2019-2020 Household Size Confirmation Form
Student Name: ______________________________ Student ID: _______________________
In order to determine your eligibility for student aid, please complete the information below, print and sign in ink,
and upload the form in your To-Do list in Student Self Service.
Independent Students:
List all people in your household, including yourself and your spouse. Also list children who will receive more
than half of their support from you, and other dependents who live with you and receive more than half of their
support from you, between July 1, 2019 and June 30, 2020.
Dependent Students:
List all people in your household, including yourself and your parent(s). List your parents’ other children (even if
they do not live with your parents) if (a) your parents will provide more than half of their support between July
1, 2019 and June 30, 2020, or (b) they would be considered dependent students if they were completing a
FAFSA for 2019-20. Include other people if they now live with your parents and your parents provide more than
half of the other person’s support AND will continue to provide more than half of that person’s support through
June 30, 2020.
Family Member Name
Relationship
Age
College (if attending at least half-time)
Self
Check this box if you have additional household members.
By signing below, I certify that all of the information provided above is true and accurate to the best of my knowledge. I
acknowledge that if I purposefully falsify information on any financial aid document, I may be subject to a fine, prison, or
both.
Signature: ________________________________ Date: ___________________
Parent Signature: __________________________ Date: ___________________
(For Dependent Students)