Fillable 2020-2021 Dependent Student Statement of Support (Washington State Community College)

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2020-2021 Dependent Student Statement of Support (Washington State Community College)

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Office of Financial Aid
710 Colegate Drive, Marietta, OH 45750
Phone: 740.568.1908 Fax: 740.376.0257
E-mail: finaid@wscc.edu
2020-2021 Dependent Student Statement of Support
Student Name: ___________________________________ WSCC ID: _______________ DOB: _____/_____/________
Parent Name: ___________________________________________________________
Based on the information provided on your Free Application for Federal Student Aid (FAFSA), we need more information
about how your parent(s) meet their living expenses. Please explain in detail how your parent(s) meet their financial
obligations such as rent/mortgage, food, utilities, medical costs, child care, transportation, miscellaneous expenses, etc.
1.) Does the student live in the parent(s)’ household? Yes No
2.) Please describe the parent(s) living expenses in 2018 and how those expenses were met.
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
3.) Parent(s), do you have any income? If so, how much do you receive per month? (Please include Job and Family
Services Benefits (TANF), Social Security, unemployment, child support, disability, etc.)
Source of Income Amount per month
______________________________________ ______________________
______________________________________ ______________________
______________________________________ ______________________
______________________________________ ______________________
______________________________________ ______________________
______________________________________ ______________________
Please Continue on the Back →
4.) What monthly expenses do the parents have and how much do the parent(s) pay towards these expenses each
month? Please itemize parent(s) expenses per month (i.e., rent/mortgage, food, utilities, childcare, etc.), how
much the parent(s) pay towards each type of expense, and the amount and source of assistance the parent(s) may
receive to help with each type of expense.
Type of Expense Total Cost per month Amount parent pays Amount & Source of other assistance
Rent/Mortgage _________________ ________________ ______________________________
Food _________________ _________________ ______________________________
Utilities (gas,
electric, water etc.) _________________ _________________ ______________________________
Transportation
and Insurance _________________ _________________ _______________________________
Medical expenses
and Insurance _________________ __________________ _______________________________
Clothing _________________ __________________ _______________________________
Cell Phone _________________ __________________ _______________________________
Childcare _________________ __________________ _______________________________
Other _________________ __________________ _______________________________
Other _________________ __________________ _______________________________
5.) SIGNATURE STATEMENT - By signing this verification form, I certify that all of the information reported is complete,
true and correct.
Student’s Signature: ________________________________________________Date: __________________
Parent’s Signature: _________________________________________________Date: __________________
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2020-2021 Dependent Student Statement of Support (Washington State Community College)

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Completed 26 July 2020

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