University of the Incarnate Word
Office of Financial Assistance
Dependent Without Parent Support Documentation
4301 Broadway, Box 308
San Antonio, TX 78209
Phone: (210) 829-6008
Fax: (210) 283-5053
finaid@uiwtx.edu
www.uiw.edu/finaid
Revised 11/2020
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Last Name First Name MI Student ID Number or SSN
Dependent students must provide parent information on the FAFSA in order to complete the application process. Students
who are unable to secure parent information because a parent refuses to complete the FAFSA are still dependent students,
and not eligible for independent status. By federal regulation, these students may still complete the process without
parent information; however, they
will be eligible for unsubsidized direct loans only, up to the dependent annual limits –
($5,500 Freshmen, $6,500 Sophomores, $7,500 Juniors/Seniors)
Dependent students without parent information on the FAFSA are ineligible for grants, work program funds or subsidized
direct loans.
Required Documentation:
Students whose parents refuse support are not eligible for a dependency override, but they may be able to receive
unsubsidized Stafford loans only. For a student to be eligible for this provision, the student must provide documentation
(1) that their parents refuse to provide information for their FAFSA and (2) that they do not and will not provide any
financial support to them. Include the date support ended. If the parents refuse to sign and date a statement to this effect,
students must get documentation from a third party (the student is not sufficient), such as a teacher, counselor, cleric, or
court.
Students providing the required documentation can be awarded the student unsubsidized Stafford loans up to the
maximum the student would normally be eligible for depending on their grade level (but not the amount a student can get
when their parent is unable to get a PLUS loan).
Student Certifications:
I understand that this form documents that I will not have parent information on my FAFSA application, because my
parent refuses to provide information. I understand that submitting this for the current academic year will allow
consideration for unsubsidized direct loans only. I will not qualify for grants, federal work programs, or subsidized direct
loans. I will be eligible for the unsubsidized amount up to the amount for dependent students by grade level.
The last date of parent support was:
Student Signature: ______________________________________________ Date: _______________________
Parent Certification:
I certify that I will not provide any information on the student FAFSA or provide any support for the student during the
academic year.
Date:
The last date of support for the student was:
Parent Signature:
Parent Telephone Number: Email:
Third P
arty Certification (if parent refuses to complete form):
Attach a statement indicating the parent lack of support and date support ended to document parent refusal to provide
information for student on the FAFSA application. Examples of acceptable third parties: high school counselor,
clergyman, other relative.
DEPEND
