FAMILY CLARIFICATION FORM
DEPENDENT - 2021-2022
Student Name Southeast Tech ID#
The number of household members and/or the number of household members in college as reported on the Verification
Worksheet you provided does not match the information reported on the 2021-2022 FAFSA. Please complete this form
in full and return to the Financial Aid Oce at your earliest convenience to resolve the conflicting information.
Number in Household on FAFSA: Number in College on FAFSA:
Number in Household on Worksheet:
Number in College on Worksheet:
CORRECT Household Size: CORRECT Number in College:
Use the spaces below to document the confirmed family information from above.
A. Please identify the people in your parents’ household, include your self and your parent(s):
• If your parent is remarried, include your step-parent
• If your parents support other people and will continue to provide more than half of their support between
July 1, 2021 and June 30, 2022 (such as their other children), include them in the household.
• If your parents’ other children would be required to provide parental information when completing the FAFSA,
include them in the household.
Name (First & Last) Age Relationship
Student/Self
B. Please identify the people listed in the above household who will be attending college at least half-time between
July 1, 2021 and June 30, 2022 and will be in a degree or certificate program.
Name
Student/Self
Name of College/Post Secondary School
Southeast Technical College
ATTENTION: If the number in college has increased from the number originally reported on the FAFSA, a copy of the
class schedule for each non-Southeast Tech student must be attached to this form. The schedule(s) must clearly show
the student’s name, the school’s name and the time period for the classes shown.
I understand that Southeast Tech may require additional documentation and will submit electronic corrections to the
FAFSA if needed.
Parent Name (please print) Parent Signature Date
SOUTHEASTTECH.EDU
Updated: December 1, 2020
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