ECC Student ID #_________________
2019-2020 Professional Judgment on Income
Student’s Name: _____________________________________ SSN: _________________________________
Complete Address: _________________________________________________________________________________
Email Address: ____________________________________________________________________________________
Telephone #: _________________________________________ Date of Birth: ________________________________
The East Central College Financial Aid Office understands that total household income and household size changes may occur from year to year.
Changes to income and household size (among other changes) may affect the original results of the students 2019-2020 Free Application for Federal
Student Aid (FAFSA). Federal Regulations allow ECC to review unusual circumstances on a case-by-case basis, and allow limited adjustments to be
made to the original financial data reported on the FAFSA; consequently, the amount and types of financial aid the student is eligible to receive may
change. This form is used for reporting significant changes that have occurred. Action will be taken when the Financial Aid Office receives all
required documentation, including the 2019-2020 FAFSA results. Only under limited circumstances may adjustments occur to a students financial
aid package or expected family contribution, and all adjustments are made at the discretion and professional judgment of the ECC Financial Aid Office.
Changes resulting from this review do not guarantee an increase in financial aid.
To ensure consideration of this unusual circumstance appeal, E CC will complete a full verification of all data. Upon receipt, the information will
be evaluated to determine the students eligibility for financial aid. An email will be sent to notify the student of the results of this evaluation (Please
allow 2 - 4 weeks for review and notification).
Students should be aware that ECC is not required to offer unusual circumstances appeals; therefore, if the financial aid administrator determines that an
appeal is not appropriate, the decision cannot be appealed.
If the student is selected for verification that process must be completed before any adjustments can be applied.
1) Check the family member that experienced the unusual circumstance:
Father/Step-father Mother/Step-mother Student Students Spouse
2) Each Unusual Circumstances Appeal must include the following information for consideration:
This form, completed, signed and dated by student and the spouse or parent (if applicable);
Personal letter signed and dated by the student and the spouse or parent (if applicable) describing the situation, timeline of employment
and/or events and future plans; and,
2018 Federal Tax Returns and W2’s
3) Review the reasons listed below, check all that apply, submit all required documentation:
Loss of Employment
Letter or notification from employer concerning loss of job if this occurred during 2018.
Copy of 2018 W2’s from every employer during 2087.
Did you cash out any retirement funds (401K; Pension) during 2018?
□Yes – Provide documentation and amount
Was there a severance package?
Yes - Provide documentation and amount (amounts that are included on your 2018 taxes)
Were there any paid Unemployment Benefits in 2018?
Yes Provide documentation of approval and amount (printout showing unemployment
payments during 2018)
No Provide documentation
Attach documentation for any other source of income (business; farm; in-kind support; etc.) during 2018
Reduction in Income
(Was your total adjusted gross income less in
2018 than what was reported on your 2017 tax
Copy of your signed 2018 Federal Tax returns and W2’s.
In your personal letter, you must include your new salary or hourly wage and your hours
schedule per week
ECC Student ID #_________________
Separation or Divorce (Only if you have
done so since you filed the 2019-2020
FAFSA or if you have filed a joint tax
1. Date of legal separation: _________________
2. Physical address for each person involved in the separation:
a. Person #1-Name/Address: ____________________________________________
b. Person #2-Name/Address: ____________________________________________
3. In your personal letter also include a list of current household members, relationship to
student and their age
4. Attach any legal documents/letters relating to this separation.
□ Divorce
1. Attach a copy of divorce decree
2. In your personal letter also include a list of current household members, relationship to
student and their age
Reduction or Loss of Untaxed Income
and/or Benefits
□Unemployment Benefits:
Attach an official statement indicating termination of unemployment
compensation, stating the ending date and monthly amount received.
□Child Support
Attach a copy of Court or Child Service Agency documents stating benefit
ending date and monthly amount received.
Attach a copy of the divorce decree
□Social Security
Attach a copy of the notification you received concerning your loss of social
security income stating the benefit ending date and monthly amount received.
□Other: Please specify:
Attach supporting documentation from the resource, describing the benefit, the
timeline it was received, the reason/s it is no longer available, the ending date and
monthly amount received.
Reduction Due to Death of a Parent or
A copy of the death certificate, or obituary notice.
Are there survivor benefits (social security, life insurance, etc.)?
□Yes - Provide documentation
□No - Provide statement in your letter indicating no benefits are to be received.
4) Please indicate your 2018 Actual Income:
Type of Income
TOTAL income for
Income From Work
Unemployment Compensation/Severance
Other Untaxed Income:
(This includes disability, child support, welfare benefits, social security, alimony annuities, pension, capital gains, dividends,
etc.) Specify: ______________________________________________________________________
Mail all documents to:
East Central College
Attn: Financial Aid Director
1964 Prairie Dell Road
Union, Missouri 63084
If you have any questions, please call (636) 584-6575 or (636) 584-6588
By signing this form, I agree to provide information that 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.
Student Signature: Date: ______________________________
Date: ______________________________
For office use only: