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Financial Aid Office
2020-21 Money Appeal
Complete this form, sign, date and drop off with required documentation to the Financial Aid office, SSC L177, mail to Manchester Community College, Financial Aid Office,
Great Path, MS #11, P.O. Box 1046, Manchester, CT 06045-1046, or fax to 860-512-3381. For more information, contact the Financial Aid office at 860-512-3380.
STUDENT INFORMATION
First Name MI Last Name Banner ID Number
Parent(s) Name (for dependent students only)
If you wish reconsideration of your aid eligibility, based on significant changes in family income within the last two years, supporting documentation is required. If
the information you will report or have reported on your Free Application for Federal Student Aid (FAFSA) does not accurately reflect your current financial situation,
documentation will be reviewed to determine a possible change in eligibility that may benefit the student/family. The FAFSA must be completed first and MCC
must receive financial aid results for the student before the appeal process can begin. If you are considered a dependent of your parent(s), remember to also
complete the parent(s) sections. If you are considered an independent student, you may skip the parent(s) sections but be sure to include spouse’s income if it
applies (not for divorced/separated, widowed individuals). Explain extraordinary circumstances in a separate letter and include supporting documentation.
PART 1: CIRCUMSTANCES FOR MONEY APPEAL
Please check box (only one) with the appropriate circumstance that applies to you and your family and submit the proper supporting documentation.
In addition to supporting documentation listed below, submit your signed copies of the 2018 Tax Return Transcripts and W2 forms. If you are a dependent student,
please submit your parent(s) 2018 Tax Return Transcripts and W2 forms as well.
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A
You or your parent(s), if dependent, worked full-time in 2018 but lost employment and remained unemployed for at least 10 weeks.
Documentation required: Last day of employment ______/_______/_______ , last pay stub, Tax Return Transcripts and W2s for the last two tax years;
may also require: Asset Form,Verification Worksheet.
You or your parent(s), if dependent, have become separated or divorced after submission of your original FAFSA.
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B
Documentation required: Date of separation or divorce: ______/_______/_______ , last pay stub, Tax Return Transcripts and W2s for the last two tax
years; may also require: Asset Form,Verification Worksheet, a copy of the temporary separation order or divorce decree.
Your parent(s), if dependent, whose 2018 income was reported on the FAFSA, died after submission of the original application.
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Documentation required: Death certificate, last pay stub, Tax Return Transcripts and W2s for the last two tax years; may also require: Asset Form, Verification
Worksheet.
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D
Other circumstances.
Documentation required: Separate letter explaining in detail the income reduction in family income, last pay stub, Tax Return Transcripts and W2s for the last
two tax years; may also require: Asset Form,Verification Worksheet.
Note: Some individuals may be asked to provide proof of non-filing.
March 2020/PR
FOR OFFICE USE ONLY
Date Received _______/_______/__________ Reviewed By ______________________________
PLEASE COMPLETE REVERSE SIDE.
PART 2: INCOME INFORMATION
Please complete the income information below.
ANTICIPATED INCOME FOR 2020 Parent(s) Student
If dependent and your parents are divorced or separated, give only the
information of the custodial parent.
Wages, salaries, tips or any other income from work $ $
Other taxable income wages, salaries, tips or any other income from earned from work
Please list:
$ $
Untaxed Social Security Benefits $ $
Unemployment benefits $ $
Child support $ $
Veteran’s benefits $ $
Alimony $ $
Other untaxed income $ $
TOTAL ANTICIPATED INCOME FOR 2020 $ $
PART 3: SIGNATURES
All of the information on this form is true and complete to the best of my knowledge.
Student Signature Date
Parent Signature Date