5) Submit the following information with this form:
o A detailed letter from you explaining the following, a) the unusual situation selected above; b) name and address
of both your parents; c) the last time you had contact with each of your parents – when, where, and the nature of
the contact; d) how you have provided for yourself, or explain if someone else has supported you; and e) when
you started meeting your expenses without parental support.
o If selected for verification, provide all necessary documents for the Verification process, including but not
limited to: a copy of your 2017 Federal Tax Return Transcript (if filed) and W-2’s. If appealing due to becoming
married, a copy of your spouse’s 2017 Federal Tax
Return Transcript (if filed) and a copy of all W-2’s.
o Completed 2019-2020 Free Application for Federal Student Aid at www.FAFSA.gov. (ECC will process your
FAFSA if this appeal is approved. If this appeal is denied, you must resubmit the FAFSA with your parent(s)’
o Two (2) Dependency Status Petition Reference Forms. The Petition requires statements from at least TWO
references familiar with the family situation. At least one of the references must be from a third-party who is not a
family member. Examples of third-party references include: teachers, pastor/priest, guidance counselor, social
worker, mental health counselor, law enforcement official, and/or physician.
o A copy of your most recent cell phone bill. If unavailable, provide explanation including who pays for the cell
phone and what your relationship is to the person(s).
o A copy of your current lease agreement or mortgage statement. If unavailable, provide explanation including
where you live, who pays for the residence and utilities, and what your relationship is to the person(s).
o A copy of your proof of vehicle insurance. If unavailable, provide explanation including who pays for the
insurance and what your relationship is to the person(s).
6) Please check one:
This is my first dependency status review.
I am applying for a renewal of a previous dependency status review granted at ECC.
Your documents will be reviewed faster if they arrive as a group rather than one at a time – all documents should have your
name, SSN, and/or ECC Student ID # included. Please allow up to 20 business days for processing. Attach all supporting
documents to this form and submit in-person at the campus nearest you, or mail to:
East Central College, Financial Aid Office, 1964 Prairie Dell Road, Union, MO 63084 Or Fax to: (636) 583-6651
Or scan and email to: firstname.lastname@example.org Questions? Please call: (636) 584-6588
By signing this form, I agree to provide information will verify the accuracy of my information, if requested. If I purposely give false or
misleading information, I will be referred to the United States Department of Education’s Inspector General. If I purposely give false or
misleading information in order to qualify for Title IV funds, I may be fined $20,000, sent to prison, or both.
OFFICE USE ONLY Approved Denied