2014-2015 Household Data Form
(Independent Student)
Office of Financial Aid
.
Phone: 734.487.0455
.
Fax: 734.487.4281
.
Email: financial_aid@emich.edu
.
Web: www.emich.edu/finaid
INDHHD
As part of the Quality Assurance Verification process, please complete and submit this form regarding your household.
Signin
g this form certifies that all the information reported on it is complete and correct.
Student Signature Date
Full Name Date of birth Relationship to you Name of College
1. Self
Eastern Michigan
University
2.
3.
4.
5.
6.
Student ID
Name
1. Write the names of all the people in the student’s household. Include:
a.
The student (yourself).
b.
Your spouse, if you are married
c.
Your or your spouse’s children, if you or your spouse will provide more than half of their support
between July 1, 2014 and June 30, 2015, even if the children do not live with you.
d.
Other people, if they now live with you and you or your spouse provides more than half of their
support and will continue to provide more than half of their support through June 30, 2015.
2.
Include the date of birth of each person and their relationship to you.
3.
Add the name of the college for any household member who will be enrolled in a degree, diploma, or certificate
program at least half
-time between July 1, 2014 and June 30, 2015.
If more space is needed, provide a separate page with your name and EMU ID number at the top.
