2020 - 2021
Special Circumstances Worksheet
In cases where 2019 family income is expected to be substantially less than 2018 family income, or if you have special
circumstances we should take under advisement, you may request a review of family contribution and financial aid eligibility.
Complete and return this worksheet to the Financial Aid Office along with documentation to support your request.
Student Name Student ID Phone Number
Reasons for review of financial aid eligibility: Check condition and circle the person for whom it applies:
You / Your Spouse / Your Parent(s) were/was employed in 2018 but are/is now unemployed
or under employed.
Suggested Documentation: Proof of unemployment benefits or statement on company letterhead
from employer which specifies your last date of employment and/or date(s) of reduced hours.
You / Your Spouse / Your Parent(s) received unemployment compensation or other reported
income in 2018 and have had a loss or reduction in these benefits in 2019.
Suggested Documentation: Letter of explanation from source of benefit.
You / Your Spouse / Your Parent(s) earned money in 2018, but have/has been unable to
pursue normal income-producing activities during 2019 due to a disability or natural disaster.
Suggested Documentation: Physician’s statement or written description of natural disaster.
You / Your Parents have become separated or divorced after you submitted your application for
Federal Student Financial Aid.
Date of Separation or Divorce: / /
Suggested Documentation: Copy of divorce or legal separation documents; if unavailable, obtain
a letter from an attorney, minister, or other responsible third party (non-relative) describing
situation and date of divorce or separation.
Your Spouse / Your Parent whose 2018 income was reported on your application for
Federal Student Aid has died since you submitted your application.
Date of Death: / /
Suggested Documentation: Death Certificate; Obituary.
Dependent Student only: Your last surviving parent, with whom you had a dependency
relationship by virtue of not meeting the Federal Independent Student criteria, has died after
you submitted your Federal Student Financial Aid Application.
Date of Death: / /
Suggested Documentation: Death Certificate; Obituary.
Your Parent(s) will be attending college at least half-time between July 1, 2020 and June 30,
2021, and will be enrolled in a degree or certificate program.
Name(s) of parent(s) who meetthis definition:
College(s) that parent(s) will attend:
Suggested Documentation: Proof of enrollment from the college(s) that parent(s) attend.
Other: Please explain briefly and concisely those circumstances you wish us to consider when
reviewing your financial aid eligibility. Examples include: high unreimbursed medical expenses,
nursing home expenses, etc. Please submit proof of these circumstances with this worksheet.
Please explain your situation below to help us understand what happened to necessitate a change
with your FAFSA information (if you need more room continue on back):
Provide a copy of the 2019 IRS Tax Return Transcript for you and/or your parent(s) byvisiting irs.gov
and selecting "Get Your Tax Record".
Certification and Signatures:
I understand if I purposely give false or misleading information I may be fined, sentenced to jail, or both. I also understand
that if the income estimates provided are substantially different from what is actually earned for that year, I will lose my
ability to request any future adjustments in subsequent application years.
Student Signature Date
Parent Signature Date
Return completed worksheet(s) to:
Caldwell Community College and Technical Institute
Office of Financial Aid
E-mail finaid@cccti.edu
Caldwell Campus 2855 Hickory Blvd., Hudson, NC 28638 Watauga Campus PO Box 3318, Boone, NC 28607
Fax: 828.726.2709 Fax: 828.297.1729
For Office Use Only
Financial Aid Officer
click to sign
click to edit
click to sign
click to edit