Rev 3/2020 OVER
ADJBUD
SUNY Potsdam One Stop
, 44 Pierrepont Avenue, Potsdam, NY 13676
(315)267-2943 (t); (315)267-3067 (f); onestop@potsdam.edu
Budget Adjustment Form
Student Name (Print) ______________________________ Date
Student Signature _________________________________ ID#:
(No physical signature required if sending form from Potsdam email account) I certify that, to the best of my knowledge,
the information and supporting documentation provided accurately reflect the actual costs for the listed expenses.
What semester(s) is this adjustment for? Summer 2020 Fall 2020 Spring 2021
Listed below are the allowable expenses, followed by the *required documentation. See Cost Breakdown
on next page
Amount
Expense Fall Spring
*Required Documentation
Child Care
Computer
Instrument
Rent & Utilities
Other
Mileage
Written statement from child care provider
(Documentation must include Name, address, phone # and signature of
provider if applicable. Must have hours per week, and cost per hour.)
Receipt for computer (Maximum $1500) (Must have been purchased
within the last year) (Can only increase once during your academic career)
Written estimate or receipt for instrument and
Written justification from faculty/advisor
Written statement from landlord or copy of lease and copies of
recent utility bills (must exceed budgeted amount, see back)
e.g. Study Abroad, Student Teaching, Internship, NSE
(Must have written budget with costs)
Written statement indicating the mileage between home and SUNY
Potsdam (e.g.: print out from map quest) and the
number of days traveled per week. (Must be greater than 50
mile round trip.)
Only certain expenses directly related to your enrollment in this institution will be considered (ex. Study
abroad, rent above the standard costs, commuting from an unusually long distance, child care costs while
you attend classes.) Car insurance, car payments, cell phone, internet access, credit card payments, cable and
phone are considered non-essential personal expenses which CANNOT be considered.
IN MOST CASES, THE TYPE OF AID AVAILABLE AFTER ADJUSTMENTS MAY ONLY BE
FEDERAL OR PRIVATE LOANS.
Please complete and return this form to the Financial Aid Office along with all documentation required.
Cost of Attendance Adjustment form
Page 2
Maximum Annual Loan LimitsSubsidized and Unsubsidized Direct Stafford Loans
YEAR
Dependent
Undergraduate
Independent
Undergraduate
Graduate
First Year
$5,500
$9,500
20,500
Second Year
$6,500
$10,500
Third Year and
Beyond
$7,500
$12,500
If your loans equal these annual limits:
o Dependent Undergraduate students would only be eligible to apply for additional PLUS loan
or Alternative (Private) loan funding.
o Independent Undergraduate students would only be eligible to apply for
Alternative (Private) loan funding
o Independent Graduate students would be eligible to apply for Graduate PLUS loan or
Alternative (private) loan funding.
2020/2021 Budget Components for Off Campus Student
Room $6392/year $3196/semester
Board $3532/year $1766/semester
Travel $820/year $410/semester
Books $950/year $475/semester
If your documented costs do not exceed these figures, no adjustments will be made.
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