Financial Aid regulations assume that the family has primary responsibility for meeting the educational costs of students.
You are considered a dependent student according to the financial aid definition and your aid eligibility is determined by
using parent income and asset information in addition to your information. Dependent students are required by law to
provide parental information and signatures to be considered for financial aid.
The U.S. government has identified five conditions that, individually or in combination with one another, do NOT qualify as
“unusual circumstances” for a dependency override. Those circumstances that are not considered a basis for an appeal are:
Parent(s) unwilling to provide information on the FAFSA or for verification
Parent(s) not claiming student as a dependent on their tax return
Student is not being supported by parents and is completely self-supporting
Parent(s) refuse to contribute to the student’s education
Parent(s) live in a foreign country
Occasionally, students should be considered independent due to unusual circumstances (for example, parent is incarcerated or oth-
erwise unable to communicate due to severe health reasons, etc.). If you can document why you should be considered indepen-
dent for some other unusual reason, please provide all of the following documents for review.
What Documentation Should I Provide?
Personal Statement by Student- Attach a typed personal statement that summarizes the unusual circumstances with
your name, school ID, date and signature. Your statement should include the following information: (1) last date and
nature of parent contact, (2) location of your parents, and (3) how you are supporting yourself.
Two Personal Statements by Third Party- Attach two letters. One from a professional individual not related to you
(counselor, social worker, teacher, clergy, police etc.). The second letter should be from a non-professional individual
(relative, family friend etc.) who is familiar with your situation.
Additional Supporting Documentation (Optional)- Attach copies of any relevant supporting documentation ( court
documents, legal documents, police reports etc.)
Proof of Income- Attach a copy of your 2017 Federal Tax Transcript, 2017 W2 form(s), statement of benefits (welfare,
social security etc.) and/or statement of how you are supporting yourself if you cannot provide the documentation listed.
2019-2020 FAFSA- If you have not submitted the 2019-2020 FAFSA, complete and submit the form without
parent information.
SIGNATURE
I certify the information provided on this form is true and correct to the best of my knowledge:
We cannot accept digital signatures.
_________________________________________________________________________________________________________________________________
STUDENT’S SIGNATURE DATE
2019–2020
Dependency Override Form
Student Financial Services
1 Ferncroft Road
Danvers, MA 01923-0840
978-762-4189 www.northshore.edu/financial-services
sfs@northshore.edu
Required (please print) DEPOV
Student ID#
N 0 0
Last Name: _____________________________________
First Name: _____________________________________
The FAFSA information provided has determined
that you need to report your parents information,
but you have indicated an unusual circumstance
and you cannot provide it. All information remains
confidential. Please read and follow the directions
below. A decision will be available on your Pipeline
account.
1/24/19
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