Mail or Fax completed form to:
North Carolina Agricultural and Technical State University
Office of Student Financial Aid
1601 E. Market Street
Greensboro, North Carolina 27411
Telephone: 336-334-7973 Fax: 336-334-7954
Office of Student Financial Aid
Orphan or Ward of the Court Form 2020-2021
___________________________________________________________ Banner: XXX_________________________
Student Last Name Student First Name MI Last 6 digits only
__________________________________________________________________________________________________
Permanent Address (include apt #) City State Zip Code
_______________________________ ____________________________________________________
Cell/Home Telephone Number (include area code) Email Address
According to our records, you indicated on the 2020-2021 Free Application for Federal Student Aid (FAFSA) either both of your parents
are deceased or you are or were (until age 18) a ward/dependent of the court. Please complete and submit this form and the supporting
documentation to our office. Your request will not be processed until all requested documents have been received and reviewed.
If you answer “No” to all the questions on this form, you are not considered an orphan or ward of the court and must provide
your natural parent(s) income information.
1. Are both of your parent’s deceased? Yes No
(If one of your biological parents is still living, you must answer no.)
If you answered “Yes”, please explain your circumstances (who do you reside with and how do you support yourself). Submit
supporting documentation: Copies of your parent’s death certificates or letters from family members and clergy or other
professionals verifying your circumstances.
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
2. Are you or were you (until age 18) a ward/dependent of the court? Yes No
If you were emancipated, incarcerated, have a guardian not appointed by the court, or parents are divorced, you must answer
“No”. If you answered “Yes”, please explain your circumstances. Submit supporting documentation: Court or legal
documents verifying you are or were a ward of the court until age 18.
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
3. Were you legally adopted? Yes No If yes, please provide documentation.
4. Please explain how you supported yourself and provide an estimated amount. $_____________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Student Certification – Read carefully before you sign.
I hereby certify that all information contain in this document, including the documentation is true and complete. I affirm that I have not
knowingly provided any false statements or fraudulent documentation. I understand that if I am found to have knowingly or intentionally
given false or fraudulent statements and/or documentation, my eligibility for Federal and State student aid may be canceled. Note:
Federal regulations stipulate that evidence of fraud must be reported to the U.S. Department of Education for possible investigation by
the Office of the Inspector General and possible prosecution by the United States Attorney General’s Office.
________________________________________________ _______________
Student Signature Date
REVISED 11/19
