Fillable **EFFECTIVE FOR THE 2020-2021 AID YEAR** (Louisiana Delta Community College)

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**EFFECTIVE FOR THE 2020-2021 AID YEAR** (Louisiana Delta Community College)

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**EFFECTIVE FOR THE 2020-2021 AID YEAR**
Beginning with the 2020-2021 Aid Year (Summer 20, Fall 20, and Spring
21), we will be using a Financial Aid Document Portal
for students to
upload all requested Financial Aid Forms that are listed as “Unsatisfied
Requirements” in your LoLA account and any additional information that
we may request to process your financial aid.
Instructions for getting your forms in LoLA:
From LDCC Homepage www.ladelta.edu
Log onto LOLA – with your username and password
Under Self Service BANNER – click on FINANCIAL AID
Under Financial Aid Links-Click on Louisiana Delta Community College
Select the 2020 -2021 Award Year from the drop down and view your requirements
“Unsatisfied Requirements” will be displayed. Click on forms requested and a PDF form(s)
should display
You must first save the PDF fillable form(s) on your desktop, laptop, or phone. Next,
complete, sign (student and parent if needed; you may also sign with a digital signature), and
upload them to the “Financial Aid Document Upload” Portal at the following link:
https://www.ladelta.edu/admissions/financial-aid/financial-aid-document-upload
OR at www.ladelta.edu/. Click on Admissions > Financial Aid > Financial Aid Document Upload
(located on the side toolbar)
You must click “BROWSE”, on the portal, to attach your completed form(s) for upload
Please check your LOLA weekly for updates
Office of Financial Aid
2020-2021 Dependency Override Request
Form
&
Instructions for Third Party Documentation
Monroe Campus P: 318-345-9005 F: 318-345-9006
_________________________________________________________________________
In extraordinary and documented cases, the financial aid office has the authority to use professional judgment to
override a student’s dependency status in order to make a student independent for the purpose of applying for financial
aid. A student must be unable
to obtain his/her parents’ information because of extenuating circumstances.
Parents’ unwillingness to provide the information or inability to help support the student are not acceptable
reasons for an appeal. Students must submit a Dependency Override Request and three (3) third party reference
letters to the Office of Financial Aid for consideration of a dependency override.
The information stated in the Dependency Override Request must be verified by a third party who is aware of your
home situation and can verify the information you have provided. Examples of such persons include, but are not limited
to: employer, clergy, social worker, attorney, court official, teacher, counselor, psychiatrist, psychologist,
medical professional, law enforcement agent, immediate family member, etc.
Instructions for three (3) third party references:
Third party references must submit separate signed and dated statements, preferably on letterheads. Please include
any information of which you have firsthand knowledge and that you feel best describes the student’s situation. The
following is a list of information that MUST be included in your letter:
I. How long have you known the student?
II. Your relationship to the student.
III. When was the last time the student lived with and/or received financial support from his/her parents?
IV. Any knowledge of his/her relationship with his/her parents, and parents’ whereabouts.
V. Steps that the student has taken to establish their independence from his/her parents.
Please make sure to include your professional title, name and type of business, business address, telephone
number, and where to contact you should any additional information be required. Please see examples of
acceptable supporting documentation listed below:
• If death of parent
- Copy of death certificate and obituary
- If student and parent have different last names, provide a copy of student’s birth certificate
• If parent is in jail
- Statement from facility or courthouse indicating jail sentence and expected release date
• If parent(s) whereabouts are unknown
- Third party references must specify that parents’ whereabouts are not known
DEPENDENCY OVERRIDE REQUEST FORMS WILL NOT BE ACCEPTED WITHOUT
THE THREE (3) THIRD PARTY REFERENCE LETTERS ATTACHED!
School Code 041301 / Campus Attending
____ Monroe ____ Bastrop ____ Jonesboro ____ Lake Providence ____ Ruston ____ Tallulah ____ West Monroe ____ Winnsboro
Dependency Override Request
*Three (3) Third Party References must be attached to this form*
*MUST COMPLETE ALL ITEMS - DO NOT LEAVE ANY ITEM BLANK*
Semester: Summer 2020_______ Fall 2020 __________ Spring 2021 __________
Student
Demographics
Name ___________________________________Student ID # ____________________
Mailing Address (PO Box) _________________________________________________
City ____________________________________ State ________ Zip ______________
Best Contact Phone # _____________________ Date of Birth ___________________
Student’s Income
Information
Current Year Total Income: $_________________ Prior Year Total Income: $ _______________
(Include all sources of income: wages, untaxed income, interest income, etc.)
Student’s Present
Living Arrangements
Whom do you live with? Name:__________________________Relationship: ________________
Monthly rent and utilities: Number of years/months at current residence:
$__________________________ __________ years ___________ months
How do you support
yourself and meet
expenses? If your
income is
insufficient, explain
how you support
yourself
(roommates,
someone else is
supporting
you, etc.)
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Parent Information:
(If deceased or
unknown,
indicate so.)
Father’s Name: _________________________________________________________________
Address: ______________________________________________________________________
City, State, Zip: _________________________________________________________________
Mother’s Name: ________________________________________________________________
Address: ______________________________________________________________________
City, State, Zip: _________________________________________________________________
COMPLETE BOTH SIDES OF THE FORM AND SUBMIT TO THE OFFICE OF FINANCIAL AID
WITH THE THIRD-PARTY DOCUMENTATION LETTERS.
Explain the circumstances and history behind your home situation, why you no longer live with your parents, and
why they no longer support you. Circumstances for both parents must be mentioned. If parent(s) is deceased, a
copy of official Death Certificate must be attached.
School Code 041301 / Campus Attending
___ Monroe ___ Bastrop ___ Jonesboro ___ Lake Providence ___ Ruston ___ Tallulah ___ West Monroe ___Winnsboro
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
____________________________________________________________________________________________
_______________________________________________________________________________________
__________________________________________________________________________________________
STUDENT CERTIFICATION
I certify that the information provided on this form is true and correct. I also understand that it will be used
to override federal regulations regarding my dependency status.
I fully understand that to falsify any information on this form in order to receive Federal Title IV funds is a
federal offense and can be punishable by fine, imprisonment, or both.
I understand that if my situation changes in any way, if I move back with my parents or receive any kind of
support from them, that I must report this information to the Office of Financial Aid.
I understand that by signing this form, I authorize the Office of Financial Aid to contact my third-party
reference and verify any information supplied on this form.
Student Signature __________________________________________ Date ___________________
FOR OFFICE USE ONLY:
The Office of Financial Aid has used Professional Judgment and determined that this student is:
_______ INDEPENDENT _______ DEPENDENT
Remarks: _________________________________________________________________________________
_________________________________________________________________________________________
FA Signature ______________________________________________ Date __________________________
FA Signature: ______________________________________________ Date: _________________________
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**EFFECTIVE FOR THE 2020-2021 AID YEAR** (Louisiana Delta Community College)

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Completed 16 September 2020

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