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Mail to: NCC Financial Aid
P.O. Box 7488
Rocky Mount, NC 27804
Form - 13
Nash Community College
Proof of Dependent(s) Form
This form is used to gather information from unmarried students who are under 24 years old and claim to
Student Name: ________________________________ NCC ID# ____________________________
Please answer ALL questions carefully and attach supporting documentation. DO NOT LEAVE ANY
1. Please list the names and ages of YOUR dependents and their relationship to you. You must attach legal
documentation of their relationship (e.g., Birth Certificate, Legal Guardianship, etc.).
Dependents are those people that you will support between July 1, 2018 and June 30, 2019. Include your
children if they get MORE THAN HALF of their support from you or from specific support / benefits you
receive FOR the children (such as child support payments or Social Services). Include other people only if
they meet the following criteria:
• They now live with you, and
• They now get more than half their support from you, and
• They will continue to get this support from you between July 1, 2018 and June 30, 2019.
Support includes money, housing, food, clothes, car, medical and dental care, payment of college costs, and
2. Where do the dependent(s) named above live?
With you (the student)
With your (the student’s) parent(s)
If “Other” is checked, please explain: _______________________________________________________
3. What child care provisions have you made for while you’re in class?