2019-2020 Appeal for Dependency Status Change Form D/OVRIDE
Under Federal guidelines, most traditional-aged undergraduate students are automatically considered dependent upon parents. As
a result, aid eligibility is determined using parent financial data. However, a student may have extenuating circumstances that
warrant special consideration for independent status.
This form allows a student to appeal dependency status for reasons other than:
The student is financially self-sufficient and does not live with parent(s)
Parent(s) no longer claiming the student on their tax return
Parent(s) refusal or inability to pay for the student’s education
Allowable appeal reasons may include (but not limited to) such situations as the following:
Abuse, abandonment, or neglect
Abusive family environment
Student unable to locate parents
For the appeal to be considered complete, please provide the following information:
1. A student must submit the Free Application for Federal Student Aid (FAFSA) online at fafsa.ed.gov or the CA Dream Act
Application (CADAA) at dream.csac.ca.gov and in the Dependency Status section of the FAFSA or CADAA answer the dependency
questions, and then indicate on three subsequent screens that there is a special circumstances preventing submission of
parental information. Upon submission, the FAFSA or CADAA will not calculate an expected family contribution (EFC). If the
dependency appeal is approved, the Financial Aid office will make updates to the FAFSA or CADAA which will allow the
calculation of the EFC.
2. A signed, detailed letter from the student explaining the extraordinary circumstance(s) detailing the relationship with both
biological or adoptive parents to include why you are unable to provide parental information, last time you lived with, had contact
with, and was supported by parent(s) and how you support yourself since your independence from your family.
3. Two (2) letters of support from independent sources who can attest first-hand to the extenuating circumstances. At least 1
letter must be from a neutral 3rd party in a professional capacity such as a doctor, lawyer, social worker, minister, etc. that is
familiar with your case. You may submit police reports and/or court documents in place of one letter, if applicable.
Documentation is critical and necessary in making this decision.
Check here if you had an approved dependency status change in the previous year at MSJC. Submit an updated letter
explaining your current extraordinary circumstance and/ or any changes.
CERTIFICATION
I/WE HEREBY CERTIFY THAT ALL INFORMATION REPORTED ON THIS FORM AND ANY ATTACHMENTS HERETO ARE TRUE, COMPLETE AND
ACCURATE. FALSE INFORMATION OR MISREPRESENTATION WILL BE CAUSE FOR DENIAL, REDUCTION, WITHDRAWAL, AND/OR REPAYMENT OF
FINANCIAL AID.
________________________________________________________________ __________________________
Student’s Signature Date
For Office Use Only
Approved: Dependency status changed to Independent for 2019-2020. You must appeal each year even if your circumstances do not change.
Pending: More information is needed to review your appeal. Please see comment below.
Denied: You remain dependent. Parental information is needed to complete your application process.
Reason: _____________________________________________________________________________________________________________
FA Signature _____________________________________________________________________ Date _________________________
2019-2020 APPEAL FOR DEPENDENCY OVERRIDE
STUDENT INFORMATION
Please PRINT clearly with black/blue ink
Last Name
First Name
M.I
Student ID Number
MVC Financial Aid Office * 28237 La Piedra Road * Menifee, CA 92584 * Telephone: (951) 639-5245
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