Fillable STUDENT LOW INCOME CLARIFICATION 2021-2022 (Southeast Technical Institute)

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STUDENT LOW INCOME CLARIFICATION 2021-2022 (Southeast Technical Institute)

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STUDENT LOW INCOME
CLARIFICATION 2021-2022
Student Name (please print) Student Social Security Number or ID#
In reviewing your financial aid application, the family income appears unusually low. Please supply the
information below to provide a better understanding of the family’s 2019 income and expenses.
Since your income was zero, please check ONLY the source(s) of income, benefits, or support provided by
others in 2019:
DO NOT MARK ITEMS BELOW IF YOU DON’T HAVE SUPPORTING DOCUMENTATION!
Additional information will be required if source of payments are not justified.
Housing Assistance
Utility Assistance
SNAP
Unemployment
Social Security Benefits/Supplemental Security Income (SSI)/ Disability
TNAF
Child Support
Veterans Benefits
Lived with Parents
Other – List and/or explain any benefits you received not listed above. If you received
none of the benefits listed above, you MUST provide detailed information here to
explain how you handled day-to-day living expenses for you and your family.
Signature and Certification Statement
I (we) certify that all information provided is complete and correct and that no representation is made with
the intent to deceive or defraud any federal, state, or institutional aid program. I understand that if I give
false or misleading information on this form, that I may be fined, be sentenced to jail, or both. I understand I
can’t change or resubmit this form once it is received by the STC Financial Aid Oce.
Student Signature Date
RETURN COMPLETED FORM TO: Mail to:
Financial Aid
Southeast Technical College
2320 N Career Ave
Sioux Falls, SD 57107
Fax to:
605-367-8305
Scan and email to:
financialaid@southeasttech.edu
SOUTHEASTTECH.EDU
Updated: December 1, 2020
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STUDENT LOW INCOME CLARIFICATION 2021-2022 (Southeast Technical Institute)

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Completed 4 February 2021

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