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Date
Financial Aid Office
2019-2020 Number in Household and College Worksheet
Student Name: _________________________________________ CCC&TI ID #: _____________________
Phone Number:
Please check dependent or independent status below and follow the guidelines to list the people in the student’s household.
If you are a dependent student, please include:
• Yourself
• Your parent(s) used on FAFSA (including
step-parent(s)
• Your parent(s’) other dependent children if
your parent(s) will provide more than half of
their support from July 1, 2019 through June
30, 2020 or the children would be required to
provide parental information if filing a FAFSA
• Other people, only if they now live in your
parent(s’) household, and your parent(s) will
provide more than half of their support from
July 1, 2019 through June 30, 2020
• Do not list your parent(s’) college if they are
also in college
If you are an independent student, please include:
• Yourself
• Your spouse (if you are married)
• Your children if you will provide more than
half of their support from July 1, 2019 through
June 30, 2020
• Other people, only if they now live in your
household and you provide more than half of
their support and will continue to do so from
July 1, 2019 through June 30, 2020
If you have listed people outside of immediate family members (i.e. – parents, siblings, spouse, children) be
prepared to provide additional documentation proving you provide, or will provide, over 50% of their
support from July 1, 2019 through June 30, 2020 You may also need to provide a copy of the IRS dependency
questionnaire located at irs.gov for each member listed below who is not an immediate family member.
Name of College (If at least half-time student for 2019-2020)
Caldwell Community College and Technical Institute
Certifications and Signatures
Each person signing below certifies that all of the information reported is complete and correct. The student and one parent
whose information was reported on the FAFSA must sign and date. Warning: If you purposely give false or misleading
information you may be fined, be sentenced to jail, or bot
____________________________________________
h.
Student’s Signature Date
Parent’s Signature (if dependent)
Please return this completed worksheet to:
Caldwell Campus
Watauga Campus
2855 Hickory Blvd.
P.O. Box 3318
Hudson, NC 28638
Boone, NC 28607
Fax: 828.726.2709
Fax: 828.297.1729
Email: finaid@cccti.edu
Email: finaid@cccti.edu
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signature
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