Fillable 2019-20 Dependency Override Appeal (Eastern Florida State College)

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2019-20 Dependency Override Appeal (Eastern Florida State College)

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The 2019-20 Dependency Override Appeal (Eastern Florida State College) form is 5 pages long and contains:

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* This form must be submitted by the priority deadline to ensure a determination of eligibility before the Fee Due Date. Students may still apply
for aid after the priority deadlines, but EFSC cannot guarantee that late submissions will be notified of aid eligibility prior to the Fee Due Date.
01/30/19
20DO
Student Eligibility
2019-20 Dependency Override Appeal
Dependency status is determined by the answers to the questions in Step Three of the Free Application for Federal
Student Aid (FAFSA) and dependent students must submit parental information. If unusual circumstances exist, a
dependent student may appeal to be treated as an independent student and not submit parental information.
Approved Dependency Overrides are granted on a yearly basis. Therefore, a student who was granted a Dependency
Override must reapply for a Dependency Override in subsequent academic years until such time the student
qualifies as an independent student for FAFSA purposes.
Priority Deadlines*: Fall 2019 – 07/18/19 | Spring 2020 – 11/25/19 | Summer 2020 – 04/23/20
A. Student Information
B#
Last Name First Name M.I. Student ID
B. Were you approved for a Dependency Override in a prior year?
☐ No – continue to Section C.
☐ Yes – provide a dated, typed letter explaining your current parental situation. You must include information
about both parents (biological or adoptive). Your statement should include the following information:
(1) Last date and nature of parental contact
(2) Location of your parents (if unknown, please indicate last known location)
(3) How you have supported yourself for the last 2 years
Skip to Section D on page 2.
C. Request Consideration for Initial Dependency Override
There are certain instances in which a student may be considered for a Dependency Override including, but not
limited to, parental abuse, parental abandonment, or incarceration of a parent. Self-sufficiency of the student or
parental unwillingness to financially contribute to a student’s education are not adequate grounds for a
Dependency Override.
For your appeal to be considered you need to provide the following documentation:
☐ A typed letter explaining your current parental situation. You must include information on both parents
(biological or adoptive). Your statement should include the following information:
(1) Last date and nature of parental contact
(2) Location of your parents (if unknown, please indicate last known location)
(3) How you have financially supported yourself for the last 2 years
☐ Attach two typed statements signed and dated from third parties who have knowledge of your unusual
circumstances and knowledge concerning your relationship with your parents (e.g. teacher, high school
guidance counselor, member of clergy, law enforcement representative, social worker, medical authority, clerk
of courts, etc.). If applicable, please also attach any other relevant supporting documentation (such as court
documents, police reports, etc.).
Continue to Section D.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
2
D. Student Income Information – You must check only 1 box below.
☐ I filed a 2017 IRS tax return. – Go to Section #1 below.
☐ I did not and will not file a 2017 IRS tax return. – Go to Section #2 on page 3.
☐ I was granted a tax extension, filed an amended return, was a victim of IRS tax-related identify theft, or filed a
non-IRS income tax return for 2017. – Go to Section #3 on page 4.
1. STUDENT TAX RETURN FILERS (IRS FORM 1040, 1040A or 1040EZ)
The best way to verify income is by using the IRS Data Retrieval Tool (IRS DRT) that is part of FAFSA on the
Web at FAFSA.gov. Use of the IRS DRT is strongly recommended.
Check the box that applies:
☐ I have used the IRS Data Retrieval Tool in FAFSA on the Web to transfer 2017 IRS income tax return
information into my FAFSA.
☐ I have not yet used the IRS Data Retrieval Tool in the FAFSA, but will use the tool to transfer 2017 IRS
income tax return information into my FAFSA. Verification cannot be completed until the IRS
information has been transferred into the FAFSA.
☐ I am unable or choose not to use the IRS Data Retrieval Tool in the FAFSA. I will submit to EFSC a 2017
IRS tax return transcript or a signed copy of the 2017 IRS Form 1040, 1040A or 1040EZ I filed with the
IRS. You must check one box below.
☐ My 2017 IRS tax return transcript is attached to this worksheet.
☐ My 2017 IRS tax return transcript will be submitted to EFSC later. Verification cannot be
completed until the IRS tax return transcript has been submitted to EFSC.
☐ My signed copy of the 2017 IRS Form 1040, 1040A or 1040EZ I filed with the IRS is attached to
this worksheet.
☐ My signed copy of the 2017 IRS tax form 1040, 1040A or 1040EZ I filed with the IRS will be
submitted to EFSC later. Eligibility for aid cannot be determined until one of the IRS tax
documents is received.
Note: Although the 1040 you have may include additional schedules and/or worksheets, EFSC needs only
the signed IRS Form 1040/1040A/1040EZ which typically consists of 2 pages.
A 2017 IRS Tax Return Transcript may be obtained through:
Get Transcript ONLINE
• Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript Online.”
• To use the new Get Transcript Online tool, the user must have (1) access to a valid email address,
(2) a text-enabled mobile phone (pay-as-you-go plans cannot be used) in the user’s name, and (3)
specific financial account numbers (such as a credit card number or an account number for a
home mortgage or auto loan).
The transcript displays online upon successful completion of the
IRS’s two-step
authentication.
• Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Get Transcript by MAIL
• Go to www.irs.gov and click on "Get Your Tax Record." Click on “Get Transcript by Mail.”
• Make sure to request the “IRS Tax Return Transcript” and NOT the “IRS Tax Account Transcript.”
Paper Request Form
• Complete IRS Form 4506-EZ and mail or fax to the IRS.
• Do NOT request to have your transcript mailed directly to EFSC.
• Please allow a minimum of 5-10 days to receive the transcript.
Go to Section D on page 5.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
3
2. STUDENT TAX RETURN NONFILERS
Complete this section if you will not file and are not required to file a 2017 income tax return with the IRS.
Check the box that applies:
☐ I was not employed and had no income earned from work in 2017.
☐ I was employed in 2017 and have listed below the names of all employers, the amount earned from
each employer in 2017, and whether an IRS W-2 form is attached. You are required to submit a copy of
each W-2 that was issued. List every employer even if they did not issue an IRS W-2 form.
Employer’s Name
IRS W-2 Issued
by Employer
IRS W-2
Attached
2017 Amount Earned
Suzy’s Auto Body Shop (example)
Yes(example)
Yes(example)
$2,000.00(example)
$
You must submit an IRS Verification of Non-filing Letter.
☐ My 2017 IRS Verification of Non-filing Letter is/are attached to this worksheet.
☐ My 2017 IRS Verification of Non-filing Letter will be submitted to EFSC later.
Verification cannot be completed until the IRS tax return transcript has been submitted to EFSC.
A 2017 IRS Verification of Non-filing Letter may be obtained through the following methods.
NOTE: if you have NEVER filed a tax return, you MUST use the Paper Request Form.
Get Transcript ONLINE
• Go to www.irs.gov, click under the Tools heading, click "Get Your Tax Record.”
• Click “Get Transcript Online.”
• Make sure to request the “Verification of Non-Filing Letter.”
Get Transcript by MAIL
• Go to www.irs.gov, click under the Tools heading, click "Get Your Tax Record.”
• Click “Get Transcript by Mail.”
• Make sure to request the “Verification of Non-Filing Letter.”
Paper Request Form
• Complete IRS Form 4506-T and mail or fax to the IRS
• Do NOT request to have your Verification of Non-Filing mailed directly to EFSC.
• Please allow a minimum of 5-10 days to receive the Verification of Non-Filing.
Go to Section D on page 5.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
4
3. STUDENT TAX FILERS WITH UNUSUAL CIRCUMSTANCES
If you are a tax filer with unusual circumstances for 2017, indicate below and submit all required documents
listed. Verification cannot be completed until all documents are submitted. Check the box that applies:
☐ I was granted a filing extension by the IRS.
If you are required to file a 2017 IRS income tax return and have been granted a filing extension by the
IRS you must provide:
• A copy of IRS Form 4868, ‘‘Application for Automatic Extension of Time to File U.S. Individual Income
Tax Return,’’ that was filed with the IRS for tax year 2017; AND
• A copy of the IRS's approval of an extension beyond the automatic six-month extension; AND
• Verification of Non-filing Letter (confirmation that the tax return has not yet been filed) from the IRS
or other relevant tax authority dated on or after October 1, 2018; AND
• A copy of IRS Form W–2 for each source of employment income received for tax year 2017 and, if
self-employed, a signed statement certifying the amount of your Adjusted Gross Income (AGI) and
the U.S. income tax paid for tax year 2017.
☐ I filed an amended IRS income tax return (1040X).
If you filed an amended IRS income tax return for tax year 2017 you must provide:
• A 2017 IRS Tax Return Transcript (that will only include information from the original tax return and
does not have to be signed), or any other IRS tax transcript(s) that includes all of the income and tax
information required to be verified AND
• A signed copy of the 2017 IRS Form 1040X, “Amended U.S. Individual Income Tax Return,” that was
filed with the IRS.
☐ I am a victim of IRS tax-related identity theft.
If you were a victim of IRS tax-related identity theft you must provide:
• A Tax Return DataBase View (TRDBV) transcript obtained from the IRS by calling the Identify
Protection Specialized Unit (IPSU) at 1-800-908-4490, or any other IRS tax transcript(s) that includes
all of the income and tax information required to be verified AND
• A statement signed and dated by you indicating that you were a victim of IRS tax-related identity
theft and that the IRS is aware of the tax-related identity theft.
☐ I filed a non-IRS income tax return.
• A tax filer who filed an income tax return with Guam, the Commonwealth of the Northern Mariana
Islands, the Commonwealth of Puerto Rico and the U.S. Virgin Islands may provide a signed copy of
his or her income tax return that was filed with the relevant tax authority. However, if we question
the accuracy of the information on the signed copy of the income tax return, the tax filer must
provide us with a copy of the tax account information issued by the relevant tax authority before
verification can be completed.
• A tax filer who filed an income tax return with the tax authority for American Samoa must provide a
copy of his or her tax account information.
• A tax filer who filed an income tax return with tax authorities not mentioned above, i.e. a foreign tax
authority, and who indicates that he or she is unable to obtain the tax account information free of
charge, must provide documentation that the tax authority charges a fee to obtain that information,
along with a signed copy of his or her income tax return that was filed with the relevant tax
authority.
Go to Section D on page 5.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
5
E. Certification and Signature
By signing below I certify that all of the information reported is
complete and correct.
Student’s Original Signature (cannot be signed electronically) Date
F. Document Submission
You may submit this document by the following methods:
1. EFSC DOCUMENT DROPBOX (RECOMMENDED)
Print and complete this document (including the original signatures), scan the document, and upload the
document via the Document Dropbox in myEFSC. Printers and scanners are available in EFSC’s open
computer labs and libraries.
2. IN PERSON
Submit your document in person at the Office of Financial Aid on any campus:
Cocoa
Building 11, Room 209
Monday through Thursday, 8 a.m. to 7 p.m.
Palm Bay
Building 1, Room 117
Monday through Thursday, 8 a.m. to 7 p.m.
Melbourne
Building 1, Room 137
Monday through Thursday, 8 a.m. to 7 p.m.
Titusville
Building 3, Room 125
Monday through Wednesday, 8 a.m. to 5:30 p.m.
Thursday, 8 a.m. to 7 p.m.
3. BY MAIL
Mail your document to the Office of Financial Aid on any campus:
Cocoa
Eastern Florida State College
Office of Financial Aid, C11-209
1519 Clearlake Road
Cocoa, FL 32922
Palm Bay
Eastern Florida State College
Office of Financial Aid, PB1-117
250 Community College Parkway
Palm Bay, FL 32909
Melbourne
Eastern Florida State College
Office of Financial Aid, M1-137
3865 N. Wickham Road
Melbourne, FL 32935
Titusville
Eastern Florida State College
Office of Financial Aid, T3-125
1311 N. US 1
Titusville, FL 32976
QUESTIONS?
Financial Aid Specialists are available at the campus locations listed above, by phone at 321-433-7339, and via e-mail at
finaid@easternflorida.edu.
Eastern Florida State College is committed to equal access/equal opportunity in its programs, activities, and employment.
For additional information, visit Eastern Florida State College: easternflorida.edu/go/equity.
WARNING: If you purposely
give false or misleading
information, you may be fined,
sent to prison, or both.
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2019-20 Dependency Override Appeal (Eastern Florida State College)

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Completed 21 July 2020

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