Fillable 2020-2021 SPECIAL CIRCUMSTANCE REQUEST (Texas Tech University)

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2020-2021 SPECIAL CIRCUMSTANCE REQUEST (Texas Tech University)

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RETURN TO: Student Financial Aid Office
PO Box 45011 Lubbock, TX 79409-5011
Student Financial Center | West Hall 301
or email directly to: finaid.special@ttu.edu
2021 Special Circumstance
Page 1 of 3
www.financialaid.ttu.edu
finaid.special@ttu.edu
2020-2021 SPECIAL CIRCUMSTANCE REQUEST
This application may be completed if your family’s financial situation has significantly changed from the
information reported on the FASFA .
Federal regulations provide financial aid administrators at colleges and universities the authority to make
adjustments to the information provided on the FAFSA when special circumstances exist. Such
circumstances
include the loss of employment or reduced income; separation or divorce; the death of a
parent/spouse;
extraordinary medical expenses; or the inflation of the income reported on the FAFSA by
a one-time financial event. Results of a special circumstance may vary from school to school as these
are based on the professional judgment of a financial aid administrator. Professional judgment
decisions are final.
Once your FAFSA has been processed, our office can review your request for a Special Circumstance. If you
have not already filed a FAFSA, please complete the online application as soon as possible.
Texas Tech University financial aid administrators welcome the opportunity to review your special situation.
When applicable, we will make adjustments to your financial aid application to possibly increase eligibility.
All applications must include the following:
1.
4.
3.
2.
All 2018 and 2019 W-2s for both parent/spouse and student. Emailed tax documents will only
be accepted if they are received from the student's Texas Tech email.
2018 signed 1040 or Tax Return Transcript (www.irs.gov) for both parent and student, even if
the Data Retrieval Tool was used to complete the FAFSA. Emailed tax documents will only be
accepted if they are received from the student's Texas Tech email.
Letter explaining the circumstances to be considered.
Additional documents relative to your particular circumstance.
DO NOT SUBMIT PHOTOS OF DOCUMENTS. Please scan and attach documentation to the
form in a PDF or DOCX file format. All documents must be clear and legible.
RETURN TO: Student Financial Aid Office
PO Box 45011 Lubbock, TX 79409-5011
Student Financial Center | West Hall 301
or email directly to: finaid.special@ttu.edu
2021 Special Circumstance
Page 2 of 3
www.financialaid.ttu.edu
finaid.special@ttu.edu
2020-2021 SPECIAL CIRCUMSTANCE R
EQUEST
TTU R#:
S
tudent Name
:
S
tudent Email:
Phone #:
Parent(s) Emai
l:
Phone #:
All Special Circumstance requests must include the following in addition to the information relative to your particular
circumstance. Please indicate by checking the special circumstance(s) that apply to you.
Do not submit originals, as documents will not be returned.
1. L
etter from parent/student explaining circumstances
2.
All 2018 and 2019 W-2s for both parent/spouse and student
3.
2018 signed 1040 or Tax Return Transcript www.irs.gov.
Separation / Divorce – THIS ONLY APPLIES IF BOTH PARENTS/SPOUSE INFORMATION IS ON THE FAFSA.
Name of Parent of Record on FAFSA (please print below the name of the parent whose information will remain on FAF
SA):
Has the Parent of Record Remarried?
YES
NO Date of Separation_____________________________
Court Documentation verifying legal separation or divorce
Copy of most recent pay check for parent of record
Proof of residence for each parent
Death of Parent / Spouse – THIS ONLY APPLIES IF BOTH PARENTS/SPOUSE INFORMATION IS ON THE FAFSA.
Copy of Death Certificate
Billing Statement from funeral home verifying expenses not covered by insurance
Copy of most recent paycheck stub for surviving parent/spouse
Loss of Child Support – THIS ONLY APPLIES IF CHILD SUPPORT IS REPORTED ON THE FAFSA.
Verification of child support received in current year (i.e., divorce decree, attorney general summary)
Medical – PAID EXPENSES CONSIDERED IN PREVIOUS YEARS WILL NOT BE CONSIDERED AGAIN.
One Time Payment – REQUIRED DOCUMENTATION BELOW
Letter from parent/student explaining the one-time payment or reason for the
withdrawal.
2019 Paid Receipts
2019 Medical Insurance Premium Payments
2019 Summary of payments from your pharmacy
Documents need to be sorted and submitted by patient (if medical is for more than one family member) and in chronological order. Please
make sure not to send duplicates of expenses. Documents not dated or dated outside of the current academic year will not be accepted.
RETURN TO: Student Financial Aid Office
PO Box 45011 Lubbock, TX 79409-5011
Student Financial Center | West Hall 301
or email directly to: finaid.special@ttu.edu
2021 Special Circumstance
Page 3 of 3
www.financialaid.ttu.edu
finaid.special@ttu.edu
2020-2021 SPECIAL CIRCUMSTANCE REQUEST
Student Name: TTU R#:
Student Email: Phone #:
Parent(s) Email: Phone #:
Loss of Employment/Reduction of Income – REQUIRED DOCUMENTATION BELOW
YES
NO
YES
NO
YES
NO
YES
NO
YES
NO
Amount:
YES
NO
Start Date:
Name of Person who lost job ___________________________
Relationship to Student ______________________________
Name of Previous Employer ___________________________
Last Date of Employment_____________________________
Severance Pay received?
Unemployment Benefits received?
Retirement Benefits being received?
Disability Benefits being received?
Will funds be taken out of your IRA, 401K, or other retirement
plan in order to supplement income or pay off debt
Has new employment been found?
Name of New Employer ______________________________
$
/
/
Letter from parent/student explaining circumstances surrounding the loss of income or reduction
Letter from previous employer stating last date of employment and year to date income OR
Copy of last pay check stub with year to date income information
Verification of severance pay
Verification of unemployment benefits
Verification of retirement benefits
Verification of disability benefits
Verification of funds taken out of retirement plan
Most recent pay check stub (if new employment has been found or if working multiple jobs)
Anticipated income for 2020 for employed parent(s)
I certify that the information contained on this form is correct. I understand that if I purposely give false or misleading information or forged signatures
on this form, I may be fined $20,000, sent to prison, or both; and it may result in the cancellation or repayment of all or part of my financial aid. I
understand that I must sign and return this form for my financial aid to be processed.
(Spouse signature is required except in cases of separation, divorce, or death).
Student Signature_________________________________________________
Parent(s) Signature________________________________________________
Date______________________
Date______________________
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2020-2021 SPECIAL CIRCUMSTANCE REQUEST (Texas Tech University)

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Completed 5 April 2021

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