Financial Aid Office, 1620 Edward P Smith Dr, Aberdeen, WA 98520
www.ghc.edu/finaid (360) 538-4081 Fax: (360) 538-4293 finaid@ghc.edu
Revised: 06/12/2019
2019-2020 Change in Circumstance Form
Last Name First N
ame SSN
Email Phone #
SID
This form is to request the Financial Aid Office to consider special or unusual circumstances that may affect your
eligibility for financial aid for the 2019-2020 academic year. Please follow the instructions and complete all sections of
this form. The certification on the back of this form must be signed by everyone whose information is being reviewed.
Your request will not be considered without supporting documentation and required signatures!
If you are completing this form AFTER DECEMBER 1, 2019,
you must also provide
a
n IRS Tax Transcript or a signed copy of your 2019 income tax return.
Reason for Change(s)
Please check one or more of the following conditions that apply to your situation, and provide the documentation requested.
☐ Loss of income:
You, and/or your family, have experienced a loss of earnings (or other financial resources) since 2017 that will result
in substantially less income in 2019. You must provide the following:
Attach a typed timeline and detailed statement explaining your unusual circumstances (i.e. what has
occurred to cause a loss of household income since 2017).
Attach documentation from employer(s) that verifies when employment ended.
Attach a 2017 IRS Tax Transcript (or signed copy of tax return) and all 2017 W-2 forms. You may request a
tax transcript from the IRS online at: www.irs.gov/individuals/get-transcript. If your address has
changed you will need to complete IRS Form 4506T.
Attach documentation verifying all income that was earned since January 1, 2019 to present.
If applicable, attach documentation from the appropriate agency indicating when financial benefits ended,
the total amount received in 2017, and what has been received since January 1, 2019.
☐ Divorce, separation or death of a spouse or parent since filing my FAFSA:
Since the time you originally submitted your financial aid application for processing, you have experienced a divorce,
separation or death of a spouse; or your family has experienced divorce, separation or death of a parent(s).
Attach a typed timeline and detailed statement explaining your extraordinary circumstances.
Attach documentation verifying this situation.
For Independent Students – attach a 2017 IRS Tax Transcript (or signed copy of tax return) and all 2017
W-2 forms for student/spouse.
For Dependent Students – attach parents’ 2017 IRS Tax Transcript (or signed copy of tax return) and all
2017 W-2 forms for both parents AND student’s 2017 IRS Tax Transcript (or signed copy of tax return) and
all 2017 W-2 forms.
☐ Other:
You and/or your family have experienced some other unusual situation, which has affected your ability to contribute
toward your education expenses.
Attach a typed timeline and detailed statement explaining your extraordinary circumstances.
Attach third-party documentation to verify your statements. Supporting letters must be from individuals
other than family members or friends who are familiar with your situation. These letters need to be on
letterhead.
