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Financial Aid and Scholarships
Administration Building Room 113
1910 University Drive
Boise, ID 83725-1315
Phone: (208) 426-1664
Fax: (208) 426-1305
Email: FinancialAid@boisestate.edu
SPECIAL CONDITIONS - 2019 Income Review
Deadline for submitting this form: November 15, 2020
STUDENT NAME ________________________ ID _______________ PHONE _______________
According to the federal financial aid application (FAFSA), a family’s 2018 income determines federal aid eligibility for
the 2020-2021 academic year. If unexpected circumstances have reduced your household earnings since 2018, and
your family’s 2019 income is a more accurate reflection of your ability to pay for education, then you can request a
financial aid counselor to review your situation on a case-by-case basis by submitting this form with all required
documents attached.
Approval depends on your specific circumstances. Please provide detailed information in your letter of explanation
and attach documentation of your circumstances with this completed form. You may be asked to submit additional
documents or explanations. Please check your BroncoMail for any follow-up questions.
1. Which individual(s) experienced a reduction in income? Check all that apply.
Student Spouse Parents
2. What caused the unexpected financial reversal?
Layoff/Termination/Business Closure. Effective Date: . Attach a document from
employer showing effective date and severance paid. Attach documentation of unemployment received.
Decline in self-employment income. Attach signed federal tax schedules C and/or E from 2019 federal tax
return. The tax filer’s signature on the Schedule C or E is required.
Quit or reduced employment to attend school. Effective Date: . Attach document
from employer stating effective date.
New employment with lower wages: Effective Date: .
Other. Please specify: ______________________________________________ Attach documentation.
3. Attach the following:
Detailed letter explaining the unique circumstances that caused a change in your family’s income from 2018
to 2019 and how this change has impacted your ability to pay for educational costs.
Documentation of student’s income from 2019, including student’s W-2s and student’s IRS tax return
transcript. If student did not work (or file taxes) in 2019, please include this information in your letter.
IRS transcripts of 2019 tax returns for all individuals on your FAFSA who file 2019 taxes.
Request your IRS tax return transcript online at www.irs.gov/transcript or at your local IRS office. This
transcript is a special view of your tax return and is on IRS letterhead. It can be requested from the IRS
approximately 2-4 weeks after you file taxes electronically. If you mailed your return, it takes about 6 weeks to
become available. (Note: A transcript is different from your tax return, and we need the return transcript.). If
you cannot obtain a tax transcript, you can submit a signed copy of your 1040.
W-2s and 1099s from 2019 for all individuals on your FAFSA. Provide copies we can keep.
Page 2 Special Conditions 2019 Income Review
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4. Complete the Income and Assets chart using annual gross income for 2019.
Independent students must complete each item for student (and spouse, if married).
Dependent students must complete each item for student and parent(s).
2019 Income and Assets
Student (and spouse)
5. Print this page to sign. Student signature is required.
Independent students: If you are married, your spouse must sign. Dependent students: One parent must sign.
CERTIFICATION: I certify the information provided is true. I understand if I use false information to
establish eligibility for federal student financial aid, I could be subject to a fine, jail, or both.
Student _____________________ Date ___________ Parent 1___________________ Date _____________
Spouse ______________________ Date ___________ Parent 2____________________ Date _____________