2020-21 Dependency
Override Renewal
Request
Louisiana College Financial Aid Office 1140 College Dr Box 582 Pineville, La. 71359
Phone (318) 487-7386 Fax (318) 487-7449 Email: financial_aid@lacollege.edu
https://www.lacollege.edu/students/financial-aid/
Page1
File your 2020-21 FAFSA application prior to submitting this form.
F. Certification and Signatures Each person signing this worksheet certifies that all of the information reported on it
is complete and correct. The student whose information was reported on the FAFSA must sign and date. Warning! If
you purposely give false or misleading information you may be fined, sentenced to jail, or both.
Student Signature: _____________________________________________________ Date___________________
This worksheet must be signed and dated to be valid. Electronic and/or digital signatures are not valid.
For Office Use Only
D/O Renewal Approved
Update dependency field to “Ifor independent
D/O Renewal Denied
Comment(s) Supporting Decision:
Processed/Reviewed By:
Date:
A. Student Information
Student’s Name: ________________________________________________
LC ID: ______________________
B. Information
This request is only for students who had an approved Dependency Override Appeal at Louisiana College for the 2019
20
academic
year. Note:
if you previously completed a Dependency Override due to homelessness or self-supporting and at risk of
homelessness or similar circumstances, please stop and contact the Financial Aid Office.
A student with an approved Dependency Override Appeal for the 2019-2020 aid year at LC who does not meet the federal criteria
for independent status on the 2020-2021 FAFSA or CA Dream Act application may submit this Dependency Override Renewal
Request. Upon receipt of your request, our office will determine if circumstances continue to exist for granting independent status.
I understand that if my Dependency Override Renewal Request is approved additional documents may be required to complete my
financial aid application (once lc has updated my FAFSA application to reflect my Independent Status). I am responsible for
submitting all requested documents in a timely fashion.
C. Personal Statement In the space below, provide a detailed explanation of the unusual & extenuating circumstances that
remain unchanged, which led to your approved independent status during 2019-2020. If you require additional space, please attach
pag
es as necessary.
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
Clear Form
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome