Academic Year: 2018-2019 Form: Confirmation of Household Member — Independent
Student’s ID #: Student’s
Name: _________________________________
Please scan and submit this completed form at www.umuc.edu/help/submit-case.cfm.
F19HMI
Your 2018-2019 Free Application for Federal Student Aid (FAFSA) was selected for a process called “verification”,
in which UMUC is required to confirm the information you reported on the FAFSA. Accurate completion
of this form is required in order to verify and process your 2018-2019 financial aid application.
According to Federal Student Aid regulations, only the following persons are considered members of your
economic household:
⇒ yourself (and, if married, your spouse);
⇒
your children, if you will provide provide more than half of
their support between July 1, 2018
and June 30, 2019, even if they do not live with you;
⇒ other people if they now live with you, you provide more than half of their support, and you will
continue to provide more than half of their support between July 1, 2018 and June 30, 2019.
Instructions: For an “Other Person” (as defined above) to be included in your household size, you must attest
to the following and complete all sections of this form. If the person in question does not meet the criteria for
inclusion, be sure to select the "WILL NOT" option when completing the next section.
All of the information on this form is true and complete to the best of my knowledge. If requested, I agree to
provide further documentation to substantiate the information provided.
Student’s Signature ____________________________________________________ Date _______________
(must be signed by hand, not typed)
UMUC Office of Financial Aid | 3501 University Boulevard East, Adelphi MD 20783 USA
I, the student, certify that I {select one} WILL WILL NOT provide more than half
of the financial support for the person listed below from July 1, 2018 through June 30, 2019.
_____________________________________________________________________________________________
Name of Person
________________________________________________________________________________
Relationship to Me
___________
Age
A separate form must be submitted for each person for whom confirmation has been requested.
