Financial Aid Office/Enrollment Services
452 South Anderson Road, Rock Hill, South Carolina 29730
Phone (803) 327-8008 Fax (803) 981-7278
. Student Information
___________________________________________ ___________________________
Student’s Last Name, First Name, M.I. Student’s College ID Number
Student’s Home Phone Number (include area code)
Student’s Cell Phone Number
B. Child Support Paid
List below the names of the persons who paid the child support, the names of the persons to whom the
child support was paid, the names of the children for whom the child support was paid, and the total
annual amount of child support that was paid in 2016 for each child.
Do not include children below that you also included in your household size.
Name of Person Who
Paid Child Support
Name of Person to
Whom Child Support
was Paid
Name of Child for Whom
Support Was Paid
Amount of
Child Support
Paid in 2016
We did NOT pay child support to another household in 2016.
Note: If we have reason to believe that the information regarding child support paid is not accurate, we
may require additional documentation, such as:
A copy of the separation agreement or divorce decree that shows the amount of child support to be
A signed statement from the individual receiving the child support certifying the amount of child
support received; or
Copies of the child support payment checks, money order receipts, or similar records of electronic
payments having been made.
C. Certifications and Signatures
Each person signing below certifies that all of the
information reported is complete and correct.
The student and one parent whose information was
reported on the FAFSA must sign and date.
___________________________________________ ________________________
Student’s Signature Date
___________________________________________ ________________________
Parent’s Signature (for dependent students) Date
WARNING: If you purposely give false or
misleading information you may be fined,
be sentenced to jail, or both.
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