T:\Forms\2021\Revision Request Form-2021-Parent.docx
Instructions: The remainder of this worksheet should be completed and signed by the parent. We may be able to
use the parents projected resources for the 2020 tax year instead of the actual resources from the 2018 tax year to
determine the parent contribution. Documentation is needed to process requests for expenses.
Read and fill out each section carefully to prevent errors. Complete ALL sections. Steps: 1) In Section B, indicate the
type of change. 2) In Section C, check all appropriate boxes. No amounts are required. 3) In Section D, complete BOTH
columns of the Worksheet. Use whole dollar amounts, no cents. If parent is currently married and not separated, provide
BOTH parents income information. Where the question does not apply or the answer is “none”, enter zero. Leaving
blanks may delay the processing of your request.
Section B: TYPE OF CHANG
E (please check and complete all appropriate selections)
PERMANENT CHANGE IN PARENTS MARITAL STATUS
1. Type of marital status change: ___ widowed ___ separated ___ divorced
2. Date of marital status change: ___________
If a permanent change has occurred since the FAFSA was submitted, we may be able to recalculate using the
information for only one parent. For divorced or separated parents, report information for the parent the student
lived with the most during the last 12 months. If this is equal, provide information for the parent who provided the
most financial support to the student in the last calendar year that the student was supported by a parent. NOTE:
If parent married after filling out the FAFSA, you do not have to report it this year unless you are reporting other
changes. If you are reporting changes, parent’s and stepparent’s information must be reported here and on future
financial aid applications.
DECREASE IN PARENT/STEPPARENT EARNED INCOME
1. Date of income change: ___________ Name of Parent with income change: _____________________________
2. Income change is due to: ___ Loss of Job ___ Reduced hours ___ Job Change ___ Retired ___ Loss of
Unemployment Benefits ___ Other (explain: ___________________________________________________)
3. Did, or will parent[s] receive Unemployment Benefits during the time period 07/01/20-06/30/21?
___ YES ___ NO (
U*** if yes, report GROSS amounts in Section D, Category 1U
)
INCREASE IN PARENT/STEPPARENT EXPENSES (report amounts in Section D, Category 3, attach documentation)
OTHER PARENT CIRCUMSTANCES: Parents should attach a separate signed letter explaining how their ability to
contribute has been affected. Include any supporting documentation. We will notify you if we need additional information.
PARENT MUST COMPLETE SECTION C & D ON THE OTHER SIDE OF THE FORM
2020-2021 PARENT
REVISION REQUEST
***FOR DEPENDENT STUDENTS ONLY***
DUE TO DECREASE IN RESOURCES OF PARENT OR STEPPARENT
20-21
PARENT
Revision
TC:1
4
For Office Use Only: ____ Approve ___ Deny Initials:______ Process date:___________
___ Professional Judgment used ___ Projected income better reflects circumstances
___ expenses affect ability to contribute ___ other: ________________________________________
___________________________________________________________________________________________
For Office Use Only
Prior TR/EFC ______/_______
New TR/EFC ______/________
Section A: STUDENT INFORMATION (please print)
_______________________________________ _____________________ ___
*SID FIELD (BELOW) IS REQUIRED*
__________________________________________
Address (include apt # if applicable)
___________________________
(______) ______ _______
Daytime Phone (include area code)
I certify that all information provided on this form is true and complete to the best of my knowledge. If an adjustment is granted based on estimated income, I agree
to report any increase in that income to the Financial Aid office. *If electronically signed, I understand that a digital or electronic typed signature has the same legal
effect, and can be enforced in the same way, as a written signature. *
Student Signature __________________________________________ Date ________________
*Print/Save & Clear buttons
are at bottom of 2nd page*
