Fillable Appeal-coa-18 University OF Central Missouri

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Appeal-coa-18 University OF Central Missouri

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University of Central Missouri
Office of Student Financial Services
P.O. Box 800
Warrensburg, MO 64093-5178
Phone 660-543-8266 | FAX 660-543-8080
On-line: www.ucmo.edu/contactsfs
Webpage: www.ucmo.edu/sfs
Appeal
Cost-of-Attendance
Increase
UCM Office use only
EXPEN 18/19
_____________________________________________ 700_______________________________
Student's N
ame (please print) UCM ID Number
Enrollment Period (check only one):
2018/19 9-Month School Year 2018 Fall Semester 2019 Spring Semester 2019 Summer Session
The following circumstance(s) apply to my situation (mark one or more):
____ Higher-than-normal tuition and fee charges. Explain below.
____ Books and supplies. Explain below. You must submit photocopies of documentation (receipts)
verifying your higher-than-normal costs.
____ Transportation and travel. Explain below. You must provide documentation.
____ Childcare. You must provide documentation of expenses and child(ren) names and ages from the
daycare provider with his/her signature.
____ Are you or do you anticipate receiving outside assistance (such as DFS, Head Start, or Voc Rehab)
for childcare? [ ] No [ ] Yes, I expect to receive $___________ from ______________________.
Amount Agency
Explanation of Circumstances. Be sure to include the amount of additional assistance you wish to be offered.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
(Continue on next page or attach a signed statement to this form.)
Please p
roceed to Page 2 …
Appeal_COA_18.pdf Page 1 NOV 3, 2017
Page 2 – Appeal: Cost-of-Attendance Increase
Student’s Last Name__________________________________ UCM # 700___________________________
Exp
lanation of Circumstances (continued)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
(Attach additional page(s) and other supporting documentation, if appropriate).
I certify that the information I’ve provided is true and accurate and that I’ve not in any way
misrepresented my financial circumstances. I understand that any changes to my financial aid
eligibility and/or award offers will be made at the discretion of the UCM Office of Student
Financial Services, in accordance with federal and UCM financial aid regulations and guidelines,
and the availability of sufficient funds.
_____________________________________________________ _______________________
Student Signature Date
Complete and submit this document to the UCM Office of Student Financial Services in person
(1100 Ward Edwards Bldg.) or by mail (Student Financial Services, P.O. Box 800, Warrensburg
MO 64093-5178), or by fax (660-543-8080). You’ll be notified within ten business days.
Appeal_COA_18.pdf Page 2 NOV 3, 2017
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Appeal-coa-18 University OF Central Missouri

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Completed 19 November 2019

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