Financial Aid Office, 2755 E. Napier Avenue
Benton Harbor, MI 49022
Phone: 269-927-8112/ Fax: 269-927-8183
Email: finaid@lakemichigancollege.edu
Request for Review of Dependency Status | 2020-2021
Students First Name Last Name Middle Initial LMC ID
Proving self-sufficiency and/or living on your own are not adequate reasons for changing the dependency status and will
not be considered as an appealable circumstance. However, if there is an unintentional, involuntary, and uncontrollable
break in the relationship between parents and student, LMC may be able to consider you an independent student. To make
that determination we will need a detailed written explanation and supporting documentation.
Financial Aid Specialists will review your appeal based on the documentation submitted and notify you of the results.
Incomplete appeals without the required supporting documentation will not be reviewed.
1. Your custodial parent has died and the other natural parent is still living. You, however, neither have
had contact with nor received any financial support from the living parent for a significant period.
Required Documentation:
Letter from you explaining the situation in detail.
A copy of the death certificate for the deceased custodial parent.
Two letters from an objective third party, which supports your claim.
2. Your family situation is unsustainable. The dysfunction may result from physical abuse, emotional
abuse or drug/alcohol abuse. In many cases, a professional counselor will have recommended living
apart from your parent(s) household.
Required Documentation:
A letter from you explaining the situation in detail. And,
At least one letter (on official letterhead) explaining the situation in detail from any of the following:
a minister, social worker, high school counselor, teacher, doctor or another counseling professional.
o If providing two letters from the above, you may not need to provide any further
One or more of the following
o A letter from someone other than a relative or a friend (i.e. the parents of a friend of the
student, a neighbor, an employer).
o Police or court reports
o Documentation from a social agency.
3. You are an unaccompanied homeless student.
Required Documentation:
A letter from the student explaining your situation in detail-including clarification of why you consider
yourself homeless.
Affidavit attached to this document from the person the student lives with and/or supports the student.
And, one of the following:
o Two letters from an objective party that explains and confirms your homeless status,
o A letter from your high school homeless counselor, (McKinney Vento Act)
If your high school counselor provides a letter, you only need the affidavit as the other
provided documentation
Other unusual circumstances (i.e. parent institutionalized, foster care after age 13, adoption after age 13)
Required Documentation:
A detailed written explanation of the situation
Substantiating documentation of all unusual circumstances.
None of the conditions listed below qualify as unusual circumstances and do not constitute grounds for a dependency
override request:
1. Parents refuse to contribute to the student’s education
2. Parents are unwilling to provide information on the FAFSA or for verification;
3. Parents do not claim the student as a dependent for income tax purposes;
4. Student demonstrates total self-sufficiency
CERTIFICATION & SIGNATURE: By signing this form, you are certifying that all of the information reported on the
form is complete and accurate.
Student Signature Last 4 digits of SSN# Date
Financial Aid Office, 2755 E. Napier Avenue
Benton Harbor, MI 49022
Phone: 269-927-8112/ Fax: 269-927-8183
Email: finaid@lakemichigancollege.edu
Affidavit for Number 2 Only
To be completed by person that the student lives with and/or provides support
Student’s Name: LMC Student ID#:
The student above has indicated that he/she is unable to provide parent information due to unusual circumstances. Please complete this
form and return it to the Financial Aid Office at Lake Michigan College
1. What is your relationship to the student?
2. How long have you known the student?
3. When is the last date you are aware that the student:
a) Received financial support from parent(s):
b) Lived with a parent(s):
4. a) What is your knowledge of the student’s family history and the relationship between the student and parent(s)?
b) Why is the student unable to obtain his/her parental information for financial aid purposes?
c) Who provides support for the student?
Your Printed Name Phone #
Your Relationship to Student Your Email
I hereby certify that the above information contained in these statements is true, complete, and accurate.
Signature Date