SOWELA Technical Community College
3820 Sen. J. Bennett Johnston Ave.
Lake Charles, LA 70615
337-421-6545-Phone
337-491-2663-Fax
onestop@sowela.edu-Email
2020-2021 Special Circumstance Request Form
Student’s Name: _______________________________________ Student ID #: _____________________________
Mailing Address: ___________________________________________ Telephone Number:
___________________
Em
ail Address: _________________________________________________________________________________
Complete this form, if you or your family have unusual circumstances that may affect your ability to contribute to your 2020-2021
educational expenses. Special circumstances that may be considered are separation/divorce, death, change or loss of employment income,
unusually high medical expenses, or loss of benefits, etc. Submit this completed form with the required documentation listed below to
your campus aid office.
**Verification of your FAFSA information must be completed first before adjustments can be made. Regularly check your LOLA account
for requirements to see what documents are needed.
Required Steps for Special Circumstance Request: (incomplete request will not be accepted)
1. Complete your 2020-2021 FAFSA and have it sent to the
Financial Aid Office.
www.fafsa.gov
Federal Processor will send us your FAFSA results
2. Attach a Signed Letter specifying your unusual
circumstances
Include date(s) situation occurred
Specify all employers where job loss occurred
List ALL 2018 or 2019 employers for student, spouse, & parents
3. Provide copies of 2018 and 2019 W-2 Forms AND/OR 2018
and 2019 1099 Forms
For independent student (and student’s spouse, if married); or
For dependent student and student’s parent(s)
2018 and 2019 W-2 wages must match IRS transcript wages for both years,
If W-2 is not available, send 2018 and 2019 IRS Wage & Income Transcript
available at: www.irs.gov/transcript
4. Provide 2018 and 2019 Income Tax Records For 2018 and 2019 Tax Filers (send Tax Return Transcript for each person)
Independent student (and spouse if student is married) or
Dependent student and parent (parent & current spouse, or both
parents if unmarried & living together)
Request at www.irs.gov/transcript, or 1-800-908-9946
For 2018 and 2019 Non-tax Filers Request Verification of Non-Filing form
from the IRS by calling 1-800-908-9946.
Independent student (and spouse if student is married) or
Dependent student (parent and parent spouse, if married)
5. Complete Special Circumstance Request Form Complete ALL applicable sections and questions of this form, and sign the
certification statement at the end:
Independent student and spouse (if student is married)
Dependent student and parent
6. Documentation required, specific to your situation
Required documents listed under “Reason for Special Circumstance Request”
Reason for Special Circumstance Request
Reason
(check box(s) below)
Whose situation
Changed in 2019or
2020?
Documents Required (must pertain to person who had the loss)
Employment Loss
1. Employer Separation/Termination Notice or employer signed statement:
Layoff
Student
a. Must be on company letterhead
Termination
Spouse
Parent
b. Must document severance package (if received)
c. Must specify effective date of separation/termination
2. Copy of last 2019 or 2020 pay stub received from student/spouse/parent affected:
a. For All 2019 and/or 2020 employers
______________________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________________
____________________________________________________________
3. Did or Will the person who had the job loss receive unemployment?
a. Yes No (If yes, Unemployment Benefit Statement required)
4. Did or Will this person remain Unemployed for 2019 or 2020?
a. Yes No
5. Is this person now employed?
a. Yes, Date employment began_______/________ No
Divorce/Separation
Student
Parent
1. Copy of divorce decree or signed letter from lawyer (must verify separation with intent to
divorce)
2. Specify date of divorce/separation _______/_______
Death
Spouse
Parent
1. Copy of Death Certificate or full Obituary
2. Specify date death occurred: ________/_________
Excessive Medical
Expenses
Student
Spouse
Parent
1. Copy of Schedule A form 2018 or 2019 federal tax return transcript or
2. Doctor/Hospital payments for 2018 or 2019 out-of-pocket expenses that you have already
paid, beyond what your insurance covers
Other
Student
Spouse
Parent
1. Documentation necessary to provide proof of your unusual circumstances
2. Loss of alimony, child support, etc. must be documented by appropriate court order or
official documentation
3. Date(s) must be documented
2020 Income You/Family Expect to Receive
Total Estimated Annual Income from January 01, 2020 through December
Income earned from work
Student
Spouse
Parent
$ (Student)
$ (Student’s Spouse)
$ (Parent)
Taxable Income
(Unemployment Benefits, Interest/Dividend
Income, Rental Alimony, etc.)
Student
Spouse
Parent
$ (Student)
$ (Student’s Spouse)
$ (Parent)
Nontaxable Income
(TANF, SNAP, Social Security Benefits, WIC,
Child Support, Worker’s Compensation, etc.)
Student
Spouse
$ (Student)
$ (Student’s Spouse)
$ (Parent)
Certification Statement
By signing this form, I certify that all of the information on this form and any attachments are complete and accurate to the best of my
knowledge. Warning: Purposely giving false or misleading information may result in a fine, imprisonment, or both. I agree to notify
the Financial Aid Office, if any of the information provided on this form changes.
Student Signature ____________________________________________________ Date ______________________
Student Spouse Signature _____________________________________________ Date ______________________
(If student is married)
Parent Signature ____________________________________________________ Date ______________________
(Dependent students must also include parent signature)
TO BE COMPLETED BY FINANCIAL AID SCHOOL OFFICIAL
Approved:________ Denied:_________
Comments:
Printed Name of School Official ________________________________________ Title__________________________________
School Official Signature __________________________________________ Date ___________________________________
SOWELA Technical Community College does not discriminate on the basis of race, color, national origin, gender, disability, or age in its programs and activities. The following person has been
designated to handle inquiries regarding the non-discrimination policies:
Title: Compliance Officer
Address 3820 Sen J Bennett Johnston Ave
Telephone No.: 337-421-6565 or 800-256-0483
Email: complianceofficer@sowela.edu
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