OFFICE OF FINANCIAL AID
AND SCHOLARSHIPS
Check your myClackamas account for all financial aid correspondence and your Award Letter.
Secure submission of documents can be completed in person, by mail, or fax to:
Office of Financial Aid and Scholarships · Roger Rook Hall · 19600 Molalla Avenue, Oregon City, OR 97045
Phone: 503-594-6082 · Fax: 503-722-5864 · e-mail: finaid@clackamas.edu · www.clackamas.edu
02/28/20 Dp
FAC20AWP
2020-2021 DEPENDENCY OVERRIDE REQUEST
(Summer Term 2020 – Spring Term 2021)
Student Last Name Student First Name
Student ID# Date of Birth
CLARIFICATION:
Parent information is usually required on the Free Application for Federal Student Aid (FAFSA) for
students who meet the criteria of a dependent student based on congressional definitions. In unique situations such as
documented abandonment, parental drug abuse, parental mental incapacity, physical or emotional abuse, parental
incarceration, or severe estrangement, the financial aid office may determine a student to be independent for FAFSA
purposes and thus not require parental information. Reluctance to request the income information from the parents or the
unwillingness of the parents to pay for college or provide information for the FAFSA are not acceptable reasons to make a
student independent.
NOTE: If you are an Unaccompanied Homeless Youth as defined by the McKinney-Vento Homelessness Act, please complete
the corresponding verification form. If you are an Orphan or Ward of the Court, please submit court documents to support that
status.
Required Reporting: Our office has reporting obligations under state and federal laws and university policy relating to child abuse,
prohibited discrimination including sexual harassment and sexual assault, and possible misconduct or criminal acts. Please let us
know if you have questions regarding this.
PROCESS:
Complete the following steps before submitting this request. Incomplete requests will be denied.
HAVE YOU PREVIOUSLY HAD A DEPENDENCY OVERRIDE APPROVED AT CCC?
If no, complete Section A below, sign, date and return this information to the CCC Financial Aid Office.
If yes, complete Section B below, sign, date and return this information to the CCC Financial Aid Office.
SECTION A:
Attach a signed personal letter stating your extenuating circumstances, what has caused you to become
independent from your parents, when you became independent, and how you have provided for your own
basic necessities (i.e. shelter, food, clothing, transportation, medical care). Attach appropriate documentation.
Submit at least two letters on letterhead from third parties who have personal knowledge of your situation and
who can verify your circumstances. Examples of third parties include guidance counselors, physicians, social
workers, clergy, or other individuals who have been involved in the circumstances in a professional capacity.
All letters must be signed and need to include a telephone number and address where the individual can be
reached for follow up questions.
I have filed my 2020-2021 FAFSA. Sign and date below and return all paperwork to the Financial Aid Office.
SECTION B:
Attach a signed personal letter providing an update on any contact with your parents since you last applied
and how you have provided for your own basic necessities (i.e. shelter, food, clothing, transportation, medical
care).
I have filed my 2020-2021 FAFSA. Sign and date below and return all paperwork to the Financial Aid Office.
By signing this request, I certify that all information is complete and accurate.
_______________________________________ __________________________________
Student Signature Date
APPROVED: _______________________ DENIED: _______________________________
