RETURN TO FINANCIAL AID OFFICE:
2019-2020
Appeal for Special Circumstances
FSFA73
S
TUDENT
I
NFORMATION
Last Name First Name M.I.
Student ID#
Your financial aid eligibility was initially determined based on the information you reported on your FAFSA regarding
your 2017 year income. However, if you have experienced changes that have created extraordinary circumstances, this
process will enable you to request a review of your situation. Our review may result in a change to your EFC (Expected
Family Contribution) and increased eligibility. Any changes to your award will be based on funding available at the time
of review, and will be retroactive to the beginning of the school year. It is the Financial Aid Administrator’s determination
to deny or approve a special circumstance and cannot be appealed.
DEADLINE to submit all required documentation:
Fall 2019: November 15, 2019 Spring 2020: April 17, 2020 Summer 2020: July 3, 2020
Special Circumstances for Consideration – Please review and indicate which Special Circumstance applies to you.
Documentation listed as required, but not submitted along with this form will cause a delay in our ability to review your
request until every required document has been received. Additional documentation that helps support your appeal, even
if not listed as required, can be submitted as well.
●List your SCC ID number at the top of all attached documentation.
●After January 2019: Students and Parents (if dependent), must submit signed personal copies of filed 2018 1040,
A or EZ (tax filers only).
●After January 2020: Students and Parents (if dependent), must submit signed personal copies of filed 2019 1040,
A or EZ (tax filers only).
You and your parent(s)
income earned in 2019 will
be less than what was
earned in 2017.
You (and/or your
spouse’s) income earned
in 2019 will be less than
what was earned in 2017.
●Typed Explanation of Special
Circumstances
●2017 US Federal IRS Tax Return
Transcript or signed Tax Return
●2017 IRS Wage & Income
Transcript or W-2(s)
●Unemployment Award Letter
●Last pay stub showing year-to-
date earnings
●Termination notice from
employer
Other Loss of Income
or Extraordinary
Expenses
●Alimony
●Child Support
●Retirement/Pension
●Social Security (taxed)
●Worker’s Compensation
●Medical/Dental
You or your parent(s)
received benefits in 2017
which have ceased or
reduced in 2018 and 2019
OR
You or your parent(s)’ paid
expenses not covered by
insurance and are over the
expected cost of attendance
OR
You or your parent(s)
received one time funds in
2017 which will not be
received in 2018 and 2019.
You (and/or your spouse)
received benefits in 2017
which have ceased or
reduced in 2018 and 2019
OR
You (and/or your spouse)
paid expenses not covered
by insurance and are over
the expected cost of
attendance
OR
You (and/or your spouse)
paid expenses not covered
by insurance and are over
the expected cost of
attendance.
●Typed Explanation of Special
Circumstances
●2017 US Federal IRS Tax Return
Transcript or signed Tax Return
●2017 IRS Wage & Income
Transcript or W-2(s)
●Original 2018 Benefit statement
listing total amount received
●Revised 2018 and 2019 Benefit
statement and/or court documents
listing updated amount to receive
and effective date
and/or
●Copy of insurance coverage
●Copy of all medical bills
