Special Conditions Appeal Form
Financial aid for the 2020-2021 award year is based on 2018 income. If you and/or your family have
had a signiﬁcant change in your ﬁnancial situation during 2019 or 2020, you may request to have
your ﬁnancial aid re-evaluated. This review will be based upon the information provided through a
process called Special Conditions Review.
SECTION A: STUDENT INFORMATION
Name____________________________________________ Student ID Number___________________
Street City State Zip
Primary Phone __________________________________
SECTION B: APPEALABLE CIRCUMSTANCES
Appealable circumstances include:
• Loss of earnings in 2019 or 2020 due to a loss of job, change in hours or reduction in pay
• Loss of untaxed income or beneﬁts in 2019 or 2020 such as child support received
• Loss of taxed income in 2019 or 2020 such as alimony
• Loss of income due to separation or divorce after FAFSA application was submitted
• Loss of one lump sum payment received in 2019 or 2020 such as severance pay or withdrawal from
a retirement program
• Payment of medical or dental expenses not covered by health insurance
• Death of a spouse/parent after FAFSA application was submitted
• Payment of elementary/secondary school expenses for tuition
If you and/or your family meet one of the criteria listed above or if you have another extenuating
circumstance that we should consider, please complete this application and submit it with the required
documentation. Additional documentation may be requested after your application is reviewed. It is
important for you to turn in ALL requested documentation as outlined on this form. If you do not provide
all required documentation, then your application may be delayed or denied and returned to you.
SECTION C: APPLICATION PROCESS
Before you submit this application, please review and complete the following steps:
1. You (the student) submit the 2020-2021 FAFSA.
2. As part of the special conditions application, the student will be selected for veriﬁcation. You and
your parent (if applicable) must complete the 2020-2021 Veriﬁcation worksheet and submit it to
our oce along with copies of the 2018 IRS Tax Transcripts (must request this transcript from the
IRS website) for you and your parent(s). If you are married and your spouse ﬁled separate, we will
need a copy of your spouse’s 2018 Federal Tax Transcript. We will not require the tax transcripts if
you opted to transfer your IRS data to your FAFSA application.
3. You must be currently enrolled at the time we process the Special Conditions Application.