2020-21 Appeal for Dependency Override
Student Name: UH ID #:
Phone Number: Date of Birth:
Federal regulations (Public Law 102-325, Sec. 480 (d)) require that the Financial Aid Office consider parent information and expect
parent contribution for students unless the student meets one of the following conditions:
1.
is 24 years or older by December 31 of the award year (born before January 1, 1997); or
2.
is a graduate or professional student; or
3.
is married; or
4.
have children who receive more than half of their support from you; or
5.
have legal dependents (other than children or spouse) who receive more than half of their support from you now and
through next year; or
6.
is an orphan or ward of the court; or
7.
is currently serving on active duty in the U.S. Armed Forces for purposes other than training;or
8.
is a veteran of the U.S Armed Forces; or
9.
is an emancipated minor; or
10.
is in legal guardianship;or
11.
is an unaccompanied youth who was homeless as determined by:
a.
your high school or school district homeless liaison,
b.
the director of an emergency shelter or transitional housing program funded by the U.S. Department of Housing
and Urban Development, or
c.
the director of a runaway or homeless youth basic center or transitional livingprogram.
The parent’s unwillingness (versus inability) or refusal to assist the student cannot be grounds for a dependency override. The
Financial Aid Office may be able to override your dependent status only if unusual circumstances exist that makes it impossible
for you to have reasonable contact with your parents. If your family situation involves an unusual circumstance, you may request
a review of your dependency status by submitting:
1.
A personal statement describing the relationship between you and your parents and the specific reasons you are unable
to secure their cooperation in completing the parent information section of the Free Application for Federal Student
Aid (FAFSA).
2.
At least one statement on official letterhead paper from an external (third party) source who can document, verify and
support your situation (e.g. social workers, counselors, clergy members, or teachers).
I certify that the information provided is true and correct to the best of my knowledge; I understand that any false statement
or misrepresentation may be cause for denial, reduction or repayment of any financial aid received.
Student Signature: Date:
Electronic signature or digital signature will NOT be accepted.
RETURN THIS FORM ALONG WITH ANY OTHER REQUIRED DOCUMENTATION TO THE COMMUNITY COLLEGE CAMPUS THAT YOU WILL BE ATTENDING:
Hawaiʻi Community College
1175 Manono Street * Hilo, HI 96720
Honolulu Community College
874 Dillingham Boulevard * Honolulu, HI 96817
Kapiʻolani Community College
4303 Diamond Head Road * Honolulu, HI 96816
3-1901 Kaumualiʻi Highway * Lihuʻe, HI 96766
Leeward Community College
96-045 Ala ʻIke Street * Pearl City, HI 96782
University of Hawaiʻi Maui College
310 West Kaʻahumanu Ave * Kahului, HI 96732
Windward Community College
45-720 Keaʻahala Road * Kāneʻohe, HI 96744
The University is committed to a policy of nondiscrimination on the basis of race, sex, gender identity and expression, age, religion, color, national origin, ancestry, citizenship, disability,
genetic information, marital status, breastfeeding, income assignment for child support, arrest and court record (except as permissible under State law), sexual orientation, national guard
absence, or status as a covered veteran. UH Title IX Coordinators' names and contact information are available at: https://www.hawaii.edu/titleix/help/coordinator/ and UH 504
Coordinators’ names and contact information are available at: https://www.hawaii.edu/offices/eeo/ada-504-coordinators/
UH HILO, UH WEST OAHU AND UH MĀNOA STUDENTS NEED TO CONTACT THEIR FINANCIAL AID OFFICE FOR CAMPUS SPECIFIC FORMS.
Rev. 04/2020
