202
0-2021 Income Reduction Request Page 1 of 2
The Financial Aid Office realizes that some students and their families may have a special circumstance that caused a substantial
reduction in their income that impacts their ability to contribute to college costs.
If you and/or your parents experienced one of the special circumstances outlined below, you may request re-evaluation of your
financial need based on 2019 income instead of 2018. You may appeal one time only. Complete this form ONLY if you and/or your
parents’ financial resources are SUBSTANTIALLY LOWER in 2019 than it was in 2018.
Complete all sections A, B, C, D and attach all requested and supporting documentation. An incomplete appeal will be denied.
A. REASON FOR REQUEST
SUPPORTING DOCUMENTATION REQUIRED
Your parent worked in 2018 and their income was reported on the
FAFSA, but is now deceased.
Copy of death certificate or equivalent
• Proof of income generated by the deceased individual after
Your parents have become separated or divorced since filing 2018 taxes.
Copy of the divorce decree, and/or proof of separate
domiciles.
UNEMPLOYMENT OR CHANGE IN EMPLOYMENT
You and/or your parent(s) received unemployment in 2018 and have
lost this source of income since filing the FAFSA.
You and/or your parent(s) worked and are no longer working now,
and/or suffered a reduction in hours or reduced wages.
Copy of most recent pay stubs showing YTD earnings for all
jobs held within the last 12 months
• Letter of Unemployment Insurance Claim Information or
other documentation showing unemployment benefits
dates, amount received, and benefits remaining
• Letter from employer (company letterhead) stating the
cause for change in hours or employment status.
You and/or your parent(s) experienced difficulty earning income due to
an unanticipated disability in 2019.
Proof of disability
• Proof of YTD earnings
LOSS OF BENEFITS OR NON-RECURRING INCOME
You and/or your parent(s) received income in 2018 (such as inheritance,
early withdrawal of Pension/401K/IRA, Social Security or Child Support)
that is not typical or expected to be received after 12/31/19.
Copy of 2018 IRS tax document that reflects the source of
income (IRS form 1040, 1099, etc.)
To request a copy of your *Federal IRS Tax Return Transcript, Wage Statement, OR Verification of Non-Filing Letter
call the IRS at 1-800-908-9946 or go to http://www.irs.gov/individuals/Order-a-Transcript
B. VERIFICATION
In addition to the items requested above for your specific circumstance, please provide each of the following:
ADDITIONAL DOCUMENTATION REQUIRED
1 Detailed letter outlining your and/or your family’s situation and the impact on your 2019 household’s income
2 2020-2021 Student & Parent Income Verification Forms Available on our website www.msjc.edu
3 2020-2021 Household Verification Form Available on our website www.msjc.edu
4
2018 Federal IRS Tax Return Transcripts* and all W-2s for student & parent(s)
If filed a 2018 Federal Tax Return
2018 Verification of Non-Filing* and all 2018 W-2s (if worked) for student & parent(s) If did not file a 2018 Federal Tax Return
5
2019 Federal IRS Tax Return Transcripts* and all W-2s for student & parent(s) If filed a 2019 Federal Tax Return
2019 Verification of Non-Filing* and all 2019 W-2s (if worked) for student & parent(s) If did not file a 2019 Federal Tax Return
2020
-2021 INCOME REDUCTION REQUEST (DEPENDENT)
STUDENT INFORMATION
Please PRINT clearly with black/blue ink
