OFFICE OF FINANCIAL AID AND VETERANS AFFAIRS
2019-2020 SPECIAL CIRCUMSTANCES APPEAL for Dependent Students
Directions
This form cannot be submitted before July 1
st
of the current year.
◄ This form MUST be completed in its entirety and brought with you to your appointment along with supporting
documentation of your claim.
◄ Pursuing this appeal does not guarantee approval.
◄ If you have not already done so, you must contact the FA Office at 609.343.5082 and schedule an appointment to meet
with a FA representative for your appeal.
◄ Any information reported on your 2019-2020 FAFSA will be corrected prior to evaluation of this appeal. (Please note that
these errors could reduce the amount of aid that you are currently receiving)
◄ Your appointment will be rescheduled if you do not provide all requested documents upon arrival.
Student Information
(Please print)
NAME____________________________________________________ SID#_________________________
ADDRESS__________________________________________________ PHONE______________________
_________________________________________________________ EMAIL________________________
Reason for Appeal – Student or Parent (Select all that apply)
Significant reduction in Loss of taxed or untaxed Death of a parent.
income income or benefits.
Loss of employment. One-time income. Unusual medical expenses not
Retirement covered by insurance.
The following documentation MUST be submitted for ALL appeals:
A written and signed personal statement explaining in full detail your special circumstance situation. If parental income
has been reduced you will need a detailed letter from your parent also. These letters MUST be specific with income
information from 2019, dates and sources of that income, and an explanation of when and why the income changed. Please
also include a projection of your income sources and amounts from current date until December 31, 2019 for both student
and parent.
A signed copy of yours and your parent’s 2017 Federal Income Tax Return Transcript and ALL 2017 W2’s. If you were
selected for “Verification” and have already submitted your tax information you do not have to resubmit unless requested.
Based on the “Reason for !ppeal” you selected above, please submit ALL required information listed.
(Example: If you checked “Loss of Employment” you will need to submit all documentation listed under that heading and you will do this for each reason
you checked)
FOR LOSS OF EMPLOYMENT SUBMIT THE FOLLOWING (Student and/or parent):
o Copy of notice of separation from the employer showing your employment status, date of termination, or reduced hours,
year to date gross earnings, and amount of severance benefits, if received.
o Last paystub received from all positions held in 2019.
o Documents related to unemployment benefits, including eligibility statement, and most recent unemployment paystub.
RETIREMENT (Parent):
o Copy of any retirement benefits received in 2019.
FOR LOSS OF TAXED OR UNTAXED INCOME OR BENEFITS SUBMIT THE FOLLOWING (Student and/or parent):
o Copy of the termination notice from the granting agency/company, court order, or document from caseworker.
