2020-2021 Appeal for
Re-Evaluation of Income
Feather River College – Financial Aid Office – 570 Golden Eagle Avenue, Quincy CA 95971
Phone (530) 283-0202 ext 603 – Fax (530) 283-4659 – Email: firstname.lastname@example.org
D. Special Circumstances for Consideration – Please review and indicate which circumstance applies to you or your family.
Documentation listed as required must be submitted along with this form to review your request. Additional documentation that
helps support your appeal, even if not listed as required, can be submitted as well.
For an Independent Student
Loss of Employment
income earned in 2019 or
2020 will be less than
what was earned in 2018.
Your (and/or your spouse’s)
income earned in 2019 or 2020
will be less than what was
earned in 2018.
• Unemployment Award Letter
• Termination notice from employer
• Last pay stub showing year-to-date
Other Loss of Income or
*Alimony; Child Support;
Retirement; Pension; Social
Security (taxed); Worker’s
Compensation; Medical or Dental;
Disability of student, student’s
spouse or parent
*You or your parent(s)'
received benefits in 2018
which have ceased or been
reduced in 2019.
*You (and/or your spouse)
received benefits in 2018 which
have ceased or been reduced in
• Original 2019 or ‘20 Benefit statement
listing total amount received
• Revised 2019 or ‘20 Benefit statement
and/or court documents listing updated
amount to receive and effective date
• Copy of insurance coverage
• Copy of all medical bills
Divorce / Separation
Your parents separated or
divorced after filing for
financial aid but no later
You and your spouse separated
or divorced after filing for
financial aid but no later than
Divorce decree or separation
agreement or proof of separate
Death of a Parent or Spouse
filing for financial aid.
Your spouse has died after filing
for financial aid.
One-time Payment Received
one-time lump sum
payment of monies in
You (and/or your spouse)
received a one-time lump sum
payment of monies in 2018.
Documents detailing one-time payment
amount, source, reason and how funds
were spent or invested
E. Certification and Signatures – Each person signing this worksheet certifies that all the information reported on it is complete and correct.
The student and one parent (if dependent) whose information was reported on the FAFSA must sign and date. Warning! If you purposely give false
or misleading information you may be fined, sentenced to jail, or both.
This worksheet must be signed and dated to be valid. Electronic and/or digital signatures are not valid.
Student Signature: _____________________________________________________ Date: _________________
Parent Signature: ______________________________________________________ Date: _________________
Student’s Name: ________________________________________________ FRC ID: ______________________
B. Purpose – To request an adjustment to the Expected Family Contribution (EFC) which resulted from your FAFSA.
Appeals for re-evaluation of income will be considered after you receive your initial award letter for the 2020-2021 aid year. Read the options
carefully and complete only those items applicable to your circumstances. After reviewing your re-evaluation of income documentation, your
aid package may remain the same or be increased based on the financial information that has been submitted. Submitting an appeal for re-evaluation
of income does not guarantee an adjustment will be made to your aid package. Decisions are final and will be communicated directly to the student
via their FRC e-mail.
Notice: Re-Evaluation of income appeals are not reviewed prior to the fourth week of the semester in which the
appeal is submitted. Processing of appeals typically take two to four weeks and may be longer at peak times.
Formula for Calculating Financial Need: Cost of Attendance – Expected Family Contribution = Need (COA – EFC = NEED)
All Appeal for Re-Evaluation of Income requests must include:
1. Personal signed statement of special circumstances pertaining to your request
2. 2019 U.S. Individual Income Tax Return or 2020 U.S. Individual Income Tax Return
3. 2019 W-2(s) / 2019 IRS Wage & Income Transcripts or 2020 W-2(s) / 2020 IRS Wage & Income Transcripts