Student Services
Financial Aid Office
2019-2020
Professional Judgment Appeal for Special Circumstances Form
Award Year __________ Date ____________
Student Name User Name/Student ID
Parent(s) Name_______________________________________________________________
Marital Status Change - to allow students/parent(s) to update their marital status if the school determines
the update is necessary to address an inequity or to reflect more accurately the student’s ability to pay.
**Additional Documents Required: 1) Student and Spouses most recent Tax Return Transcripts, 2) Dated
Marriage Certificate 3) Letter stating new number of family members who will be receiving at least 51%
support from the student/spouse
Parental Non-Disclosure- parent(s) refuse to provide required information to complete the FAFSA, do not
provide any financial support to the student, AND, will not provide support in the future. **Additional
Documents Required: 1) Signed/dated statement from parent(s) explaining in detail the circumstance for
not providing information on the FAFSA, why support has ended including the date, and confirming they
will not provide support in the future. OR, 2) Signed/dated statements from student, and an independent
third party such as counselor, teacher, pastor, court system, etc, explaining the situation as it relates to
the relationship with the parent(s) and the extenuating circumstance.
PLUS Loan Exceptional Factors - parent(s) are unable or unwilling to borrow a PLUS loan due to
exceptional factors. **Additional Documents Required: 1) Official documentation showing proof of one
of the following extenuating circumstances pertaining to the parent: Incarcerations, Bankruptcy
indicating parent(s) are unable to incur additional debt, Parent income is limited to public or federal
assistance or disability benefits, Parent is not a US citizen or permanent resident, but student is.
Loss of Income/Income Reduction – (Check all that apply) - circumstances, such as a lost job or pay cut,
result in prior earnings that may not be an accurate representation of the annual recurring income. (Please
complete section A below)
Student/Spouse
Parent(s)
**Additional Documents Required: 1) Letter from former employer, on letterhead confirming
termination, reduction in hours, pay cut, etc, 2) w-2 Forms or pay statements showing year-to-date
income, 3) Unemployment compensation claim if applicable
Kaua’i Community College does not discriminate on the basis of age, race, sex, color, national origin, or disability in its programs and activities. For
more information or inquiries regarding these policies, please contact Teresa Tumbaga, Title IX Coordinator, tumbagat@hawaii.edu, 808-245-8395 or
Alicia Sams, Student Support Counselor, samsa@hawaii.edu, 808-245-8317.
3-1901 Kaumuali‘i Highway
Līhu‘e, Hawai‘i 96766-9500
Telephone: (808) 245-8360
Fax: (808) 245-0100
An Equal Opportunity/Affirmative Action Institution
Please indicate the reason for requesting professional judgment consideration for yourself. You must document the
reason for your request and submit this form along with any non-returnable copies of documents that support your
request, to the Financial Aid Office. Any requests submitted without signature, date or documentation will not be
considered.
Please complete, sign and submit this form with a letter of explanation and the required documentation to the Financial
Aid Office.
Reason for Request
