Mail, fax, email, or deliver the completed worksheet to the financial aid office using the contact information listed below.
EMAILED FORMS MUST BE SENT FROM THE IWU STUDENT EMAIL ACCOUNT
Financial Aid Office, IWU National & Global 1900 West 50
th
Street Marion, IN 46953-9393 indwes.edu
800.621.8667 option 4 765.677.2516 765.677.2030 Fax IWUfinaid@indwes.edu
INDEPENDENT STUDENT
( ) -
STUDENT INFORMATION
________________________________________ ____ _______________________________________________
First Name M.I. Last Name
___________________ OR __________________ ______________________________________
FC19ISNH
Student ID Last 4 Digits of SSN Phone Number
HOUSEHOLD INFORMATION (INDEPENDENT STUDENT)
For questions regarding household, use the following information to determine who is to be counted as a member of your
household:
•
You, the student
•
Your spouse, if you are married
•
Your children and, if you are married, your spouse’s children if you will provide more than half of their support from
July 1, 2019 through June 30, 2020, even if they do not live with you.
•
Other people, if they now live with you and you provide more than half of their support and will continue to provide
more than half of their support from July 1, 2019 through June 30, 2020.
NUMBER IN HOUSEHOLD (INDEPENDENT STUDENT)
Complete the following chart by entering the name, age, and relationship to you of each person in the household, as defined
above. Do not include foster children.
FULL NAME AGE RELATIONSHIP TO STUDENT
1
Self
2
3
4
5
6
7
8
If more space is needed, provide a separate page with the student name and ID number at the top.
CERTIFICATION AND SIGNATURE
By signing below, I certify that all the information reported on this worksheet is complete and correct.
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to
jail, or both.
_____________________________________________________________________________ _________________
Student Signature* Date
* Must be an actual “wet” signature. A digital signature or typed font signature is not acceptable. This form may be completed and “wet” signed via a tablet
or smartphone with PDF signing capability using a stylus pen. You may need to download an app to access this feature.
