Office of Financial Aid
Phone: 212-353-4113
FAX: 917-793-3304
30 Cooper Square 2
nd
Floor
New York, NY 10003
2020-2021 Request for Consideration of Special Circumstances
The deadline for submission of these Requests is September 1, 2020 if you attend the Fall 2020
semester, and February 1, 2021 if you attend Spring 2021. The review of your request will not begin
until all documentation are submitted and it may take approximately four to six weeks to be
processed.
Please be advised that all financial aid appeal request is up to the discretion of the financial aid
office. All decisions are final and cannot be re-appealed.
T
he decision on this appeal is only valid for the academic year in which you applied for.
Student Name: ____________________________________ Student ID#_________________
All requests for consideration of special circumstances must include:
C
opy of the 2018 Complete IRS tax transcript and W-2s for the student and parent (i
f
appl
icable).
Co
mpleted 2020-2021 Verification Worksheet (If selected for verification).
L
etter explaining in detail the circumstances and the reason for your appeal.
Check the reason (s) that best describes your situation and provide all requested documentation
U
nemployment: Person’s Name: ____________________________
Relationship to Student_______________________________
P
lease write a statement explaining beginning and end date of all employment. Also
indicate beginning and ending date of any unemployment compensation as well as any
other sources of income for 2019.
Copy of the 2019 Complete IRS Tax Return Transcript and W-2s for the student and
parent (if applicable).
C
opy of the letter of termination/change in status from the employer stating status dat
e
and
any benefits received, any severance pay documentation for each employment listed in
above statement.
Copy of official statement of unemployment eligibility, if receiving unemployment benefits.
D
isability/Death: Name of disabled or deceased person: ____________________________
Relationship to Student_______________________________
P
lease write a statement explaining the circumstances.
Copy of the letter from the employer stating any benefits received.
Copy of the 2019 Complete IRS Tax Return Transcript and W-2s.
In the case of disability: copy of official statement of disability benefits, eligibility for
workers compensation, or eligibility for social security benefits.
In the case of death: copy of the death certificate or obituary.
Divorce/Separation: Date of separation or divorce: _________________________________
Relationship to Student___________________________
Please write a statement explaining the situation including the date of separation as well
as beginning and end date.
Copy of the 2019 Complete IRS Tax Return Transcript and W-2s for the student and
parent (if applicable).
In the case of divorce: copy of official divorce decree.
In the case of separation, proof of separate addresses, (i.e. Gas/electric bill), and please
address custody, child support, and alimony in a written statement.
Other: ____________________________________________________________________________
Student Signature: _________________________________________ Date: ______________
Parent Signature: __________________________________________ Date: ______________
(Parent Signature required for all Dependent Students)
Please email completed form to FAAppeal@Cooper.edu or FAX to 917-793-3304
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