Instructions: fill out form, choose ‘print’ icon then ‘save as pdf’ and email form from your device to firstname.lastname@example.org
Office of Financial Aid & Scholarships
2020-2021 Dependency Override Request
(Note: Incomplete dependency override requests will NOT be accepted)
Student Name: ______________________________________________ Student ID#:_____________________________________
Student Mailing Address: __________________________________ ___ Telephone Number:_______________________________
Email Address: ______________________________________________________________________________________________
Under Federal law your family is primarily responsible for paying for your college expenses. In very limited situations, Federal law
may allow us to consider a dependent student as independent (for financial aid purposes) when unusual conditions exist.
Examples of unusual conditions where you may be unable to provide parental data include:
● Your parents are incarcerated; or
● You have left home due to an abusive family environment; or
● You do not know your parents location, are unable to contact them, and you are not adopted.
The following DO NOT qualify as reasons for requesting a dependency change:
● You do not live with your parents or you are self-sufficient; or
● Your parents refuse to contribute to your college expenses; or
● Your parents do not want to provide their information on your FAFSA; or
● Your parents do not claim you (the student) as an exemption on their income taxes.
** Verification of your FAFSA information must be completed before adjustments can be made. Check your eligibility
requirements on your LoLA account to see which documents are required for verification, in addition to any request for additional
Select the reason for your Dependency Override Request:
If any of the following applies to your situation, please indicate below with a check mark. We will need to receive ALL listed
information below before the request can be considered.
◻ Death of custodial parent and no contact with non-custodial parent.
● Typed and signed personal statement outlining the reason for an request, including specific information and dates
● Copy of student’s birth certificate
● 2020-2021 Household Verification Form
● 2018 IRS Federal Income Tax Return Transcript
● Copy of death certificates or obituaries
● At least two signed letters from third party (non-family member) who can verify your situation from personal
knowledge. Professional references must be signed and listed on agency letterhead (law enforcement, guidance
counselor, social worker, clergy, etc.) Personal references (family member) must be signed and notarized.