College of DuPage 2020-2021 Special Conditions Review Request
Office of Student Financial Assistance
2020-2021 Special Conditions Review Request 1
05/11/2020
Last Name: First Name: Student ID:
Please complete all sections carefully. Provide all information requested and ensure that the proper boxes are marked. This form
will not be processed if any items are left blank. If, upon review, we need additional information you will be contacted via your COD
email address.
SECTION 1: HARDSHIP(S) AND REQUIRED SUPPORTING DOCUMENTATION
REQUIRED SUPPORTING DOCUMENTATION
Reduction in work hours or
partial/temporary loss of
employment
1. SUBMIT signed 2018 Federal Tax Return 1040 – AND –
2. SUBMIT letter from employer – AND –
3. SUBMIT most recent paystub
Loss of employment or Layoff
1. SUBMIT signed 2018 Federal Tax Return 1040 – AND –
2. SUBMIT “UI Finding Letter” from Unemployment Office –AND-
3. SUBMIT most recent paystub
Reduction in work income due to
illness and/or injury
1. SUBMIT signed 2018 Federal Tax Return 1040 – AND –
2. SUBMIT letter from employer or appropriate medical professional
verifying date the employee became unable to work – AND –
3. SUBMIT an estimate of when the employee should be able to
return to work – AND –
4. SUBMIT last paystub matching date employee became unable to
work
Loss of Benefits (Child Support
and/or Alimony)
1. SUBMIT signed 2018 Federal Tax Return 1040 – AND –
2. SUBMIT divorce decree with child support – AND/OR –
3. SUBMIT alimony schedules
Loss of Benefits (Workman’s Comp
and/or Long Term Disability Income)
signed 2018 Federal Tax Return 1040
2. SUBMIT notification that benefit ended – AND/OR -
3. SUBMIT paystub (Last or current) – AND/OR -
4. SUBMIT benefit statement pertaining to all other income received,
such as Short Term or Long Term disability and/or SSI disability.
4. SUBMIT schedule A of the 2018 Federal Tax Return 1040 listing the
itemized medical expenses
1. SUBMIT documentation of out-of-pocket paid medical expenses
for year being reviewed (NOTE: this does not include portions paid
by insurance, HSA, FSA, or other entity)
One time IRA or Pension Distribution
1. SUBMIT signed 2018 Federal Tax Return 1040
Divorce/Death/Separation*
Date:______________
* S
pecial Conditions request is not required if
event occurred prior to FAFSA filing and
reflects single income.
1. SUBMIT signed 2018 Federal Tax Return 1040 – AND –
2. SUBMIT divorce Decree – OR -
3. SUBMIT death Certificate – OR -
4. SUBMIT proof of separate address (i.e drivers licenses, utility bills,
petition for dissolution of marriage)
NOTE: Outstanding Debt/Bankruptcy does not meet the criteria for income reduction.
