Isothermal Community College
Office of Financial Aid
Request for Professional Judgment Adjustment to Financial Aid Application 2015-2016
Name: _____________________________________ Student Id #:
Because the Free Application for Federal Student Aid (FAFSA) is based on prior year’s income,
institutional Financial Aid Officers are allowed to use “Professional Judgment” to make
adjustments when a student (or student’s family) experiences unusual circumstances which affect
their current financial situation. Listed below are the circumstances the Financial Aid Office at
Isothermal Community College will consider. Please read through each circumstance and check the
one that pertains to your situation.
1. LOSS OF EMPLOYMENT: The student and/or the student’s spouse worked full time (at least 35 hours a week) in
2014, but has been displaced for at least eight (8) weeks in 2015. For dependent students, the student’s parents may
also be considered.
2. LOSS OF UNTAXED INCOME OR BENEFIT: The student (or spouse) received an untaxed income or benefit
during 2014, but is no longer receiving that income or benefit. This would apply to the student’s parent(s) for a
dependent student. Examples of unearned income or benefits: TANF, child support, alimony, etc.
3. EXCESSIVE MEDICAL OR DENTAL EXPENSES: The student and/or his/her family had medical or dental
expenses, paid out of pocket, in excess of $2000 during 2014. Note: to use this option the medical expenses must
show as an itemized deduction on Schedule A of the Federal Income Tax Return.
4. SEPARATION OR DIVORCE AFTER FILING THE FAFSA: The student has become separated or divorced
from their spouse since the date they filed their 2015-2016 FAFSA. This would apply to the separation or divorce of
a dependent student’s parents. Appropriate legal documentation and/or notarized certification will be required.
one-time lump sum disbursement of funds that appeared on their 2014 Federal Income Tax Return in excess of
$3000. These funds must have been a one-time disbursement and will not be received again in 2015. This would
apply to a one-time lump sum disbursement of funds for a dependent student’s parent(s). This would include such
things as a disbursement of a retirement account, a legal settlement, or an inheritance.
6. OTHER AS DOCUMENTED BY A FINANCIAL AID OFFICER: (to be completed by a Financial Aid Officer)
Student’s Signature: ________________________________________ Date: _____________________
Approved by: ___________________________________ __________________________
Staff Member’s Signature Date
___________________________________ __________________________
Director’s Signature Date
Required Documentation
Layoff notification from employer
Student’s most current or final paycheck stub
Spouse’s most current or final paycheck stub
Mother’s most current or final paycheck stub
Father’s most current or final paycheck stub
Benefit History Printout from the Employment Security Commission.
Wage History Statement from the Employment Security Commission.
W-2(s) for the year 2014
Federal Income Tax Return for the year 2014
IRS Tax Return Transcript for 2014 or “link to the IRS” by correcting FAFSA online
Household Verification Worksheet
Verification of loss of social security benefits
Verification of loss of unemployment benefits
Verification of pension/retirement roll-over
Verification of loss of child support
Statement explaining why professional judgment is being requested. This statement should be as detailed as possible
and clearly state the reason why a professional judgment is being requested.
Other: _______________________________________________________________________________________
Other: _______________________________________________________________________________________
Other: _______________________________________________________________________________________
This form was issued to the student by: __________________________________ on _______________
Name of Issuing Staff Member Date Issued
(White) 15-16 PJ DOC 7/16/2015