Fillable Dependency Override Request 2021-2022 Financial Aid (Eastern Arizona College)

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Dependency Override Request 2021-2022 Financial Aid (Eastern Arizona College)

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2021-2022 Financial Aid
Dependency Override Request
____________________________________________ ____________________________
Student’s Last Name First Name M.I. Student’s Identification (ID) Number
____________________________________________ ________________________ ___
Student’s Street Address (include apt. no.) Student’s Date of Birth
____________________________________________ ____________________________
City, State, Zip Code Student’s Email Address
____________________________________________ ____________________________
Student’s Home Phone Number (include area code) Student’s Alternate or Cell Phone Number
The basic premise underlying student financial aid is that it is primarily the responsibility of the student and
his or her family to pay educational costs. When the family resources are insufficient, financial aid may be
awarded to supplement the resources of the student and parent(s) to help pay educational expenses. By
completing this appeal, you are asking Eastern Arizona College Financial Aid Office to relieve your parent(s)
of the responsibility for using their resources to pay part or all of your college costs. Only very extenuating
circumstances will make it reasonable to approve such an appeal. Having sufficient resources to pay your
own expenses or moving out of your parent’s home because you feel it is the right thing to do after graduating
from high school are not considered extenuating circumstances to make a dependent student independent.
To consider your appeal for independent status, please complete this form and provide supporting
documentation as required.
Section I:
A. Explain, what types of financial assistance you currently receive from your parent(s)?
_______________________________________________________________________________________
_______________________________________________________________________________________
______________________________________________________________________________
B. Do you live in a property that is owned or leased by your parent(s)? Yes No
C. When was the last time you lived with your parent(s)? _____________________________________
Financial Aid Office
615 N Stadium Avenue
Thatcher, Arizona 85552
Office #: 928-428-8287
Fax #: 928-428-2391
Gila Hank Drop Box
2
Section II:
If one of the following circumstances applies to you, please check the category and provide the required
documentation.
I completed my FAFSA as single but am now married.
Provide required documentation listed below:
1. Provide a copy of your marriage license.
2. Submit a 2021–2022 Independent Student Institutional Verification Worksheets V-1. You must
include 2019 income and tax filing information for both the student and their spouse. This form can
be obtained from the EAC Financial Aid Office.
My family situation is unreasonable. The dysfunction may be the result of physical abuse, sexual
abuse, emotional abuse, abandonment, sexual orientation or drug or alcohol abuse.
Provide required documentation which supports your unusual circumstances:
1. A letter from you, the student, explaining your situation as much as you feel comfortable in sharing.
Be sure to include in your letter (1) the nature of your relationship with your parents; (2) the location
of both parents and when you last had contact with them; (3) why you cannot obtain information
and/or support from your parents; and (4) how you have been supporting yourself.
2. A letter, on an official letterhead, from a third party such as a minister, social worker, psychologist,
high school counselor, teacher, doctor, police officer, or other professional explaining their
knowledge of your situation. If you have never sought professional assistance explain this in your
letter.
3. Copies of all applicable court, police, legal documentation, or medical documentation pertaining to
your circumstance.
Certification: I certify all information on this appeal, and attached documentation, is complete and accurate. I
understand that purposely giving false information may result in a fine $20,000 and a prison sentence, or both.
WARNING: If you purposely give false or misleading information you may be fined, be sentenced to jail, or both.
Student’s Signature: Date:
Return this form to: EAC Financial Aid Office, 615 N Stadium Ave, Thatcher, AZ 85552, FAX # 928-4282391
or your Gila Hank Financial Aid Forms Drop Box.
2021-2022 Financial Aid
Dependency Override Request
Examples of acceptable court and legal documentation:
Police reports if any were filed.
Court documents if the courts were involved.
Other agency documentation, like from child protective services, if relevant.
Unusual circumstances do include:
Abandonment by parents.
An abusive family environment that threatens the student’s health or safety.
The student being unable to locate their parents.
However, none of the conditions listed below, singly or in combination, qualify as
unusual circumstances meriting a dependency override:
Parents refuse to contribute to the student’s education.
Parents are unwilling to provide information on the FAFSA or for verification.
Parents do not claim the student as a dependent for income tax purposes.
Student demonstrates total self-sufficiency.
Eastern Arizona College | Financial Aid Office
615 N Stadium Avenue Thatcher, Arizona 85552
Office: 928-428-8287 | Fax: 928-428-2391
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Dependency Override Request 2021-2022 Financial Aid (Eastern Arizona College)

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Completed 29 January 2021

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