Fillable Special Circumstance Review Request 2020-21 Financial Aid Year (Lorain County Community College)

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Special Circumstance Review Request 2020-21 Financial Aid Year (Lorain County Community College)

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The Special Circumstance Review Request 2020-21 Financial Aid Year (Lorain County Community College) form is 2 pages long and contains:

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  • 45 other fields

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File type: PDF

U.S.A. forms for Lorain County Community College

BROWSE LORAIN COUNTY COMMUNITY COLLEGE FORMS

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Page 1 of 2
Special Circumstance Review Request
2020-21 Financial Aid Year
Last Name First Name Middle Initial
LCCC Student ID #
The Financial Aid office at Lorain County Community College is given authority by federal regulations to make adjustments to information
submitted on a FAFSA on a case-by-case basis. Requests may take 2-3 weeks for review. Please do not inquire until at least 2-3 weeks have
passed. If anything additional is needed, you will be notified via email sent to your LCCC email address.
Section A:
Attach an explanation that details the unusual or special circumstance that you were unable to address on your FAFSA. Please be as descriptive as
possible. Make sure the explanation has the student's name and LCCC Student ID # at the top. Requests will not be considered without a written
statement.
Written Statement Attached
Section B: Supporting Documentation required for ALL review requests (unless otherwise noted):
Missing or incomplete information will delay processing.
2018 and 2019 Federal Tax Return Transcript or tax return (1040/1040A/1040EZ) for student/spouse.
Required for ALL review requests unless noted below. Requests will not be considered without this information.
Check this box if you previously submitted this document to our office for verification, etc.
2018 and 2019 Federal Tax Return Transcript or tax return (1040/1040A/1040EZ) for parents.
Required for ALL review requests for dependent students unless noted below. Requests will not be considered without this information.
Check this box if you previously submitted this document to our office for verification, etc.
2018 and 2019 W2s for student/spouse - required for ALL review requests unless noted below.
2018 and 2019 W2s/Schedule C/C-EZ for parent/s of dependent students - required for ALL review requests for dependent students unless noted below.
Section C: Specific supporting documentation required based on your situation:
Involuntary separation from employment or Involuntary loss of income
Effective date (do not submit until at least 8 weeks have passed):
Letter from previous employer (on company letterhead) indicating start and end dates and year-to-date earnings
Copy of most recent pay stub showing YTD earnings for the person(s) whose income was reduced or 2019 W2 when available
Statement of unemployment benefits (if received)
Divorce or separation or Death of spouse or parent **Only used if both parents' info is reported on current FAFSA
Effective date: Appropriate court documents indicating date of separation or divorce or death certificate
Medical expenses in 2020 not paid by insurance
Signed and dated summary totaling those expenses not covered by insurance in 2020. Expenses must have occurred in 2020.
Parent in college (full-time enrollment) - dependent students ONLY (Tax Return Transcripts/W2s not required)
2020-21 Parent in College Form
Loss of Child Support (Tax Return Transcripts/W2s not required)
Effective date:
Expected amount in 2020 for all children in household
Copy of court/legal documentation that shows date child support payments have/will cease
Other, please describe in detail in a written statement and submit supporting documentation.
Lorain County Community College Financial Services 1005 N. Abbe Rd, Elyria, OH 44035 Phone: 440-366-4034 Page 2 of 2
Section D: Projected Income for Calendar Year 2020
Enter "0" or "N/A" where appropriate. Do not leave any item blank. Do not include Social Security Income or Disability Benefits.
Expected Annual Income January 1, 2019 through December 31, 2019.
Student Spouse (if applicable) Parent 1 Parent 2
Name of parent 1, parent 2 according to your FAFSA.
Wages, tips, salaries. The amount(s) listed should ONLY be
income from work. DO NOT include SSI, disability, etc.
Severance Pay
Separation Bonus
Total Expected Annual Income
Section E: Household Information
Dependent students: List the people in your parents' household, excluding foster children. Include yourself, the parent(s) with whom you live, your
parents' other children and other people if your parents will provide more than half of their support between 7/1/20-6/30/21. If anyone will be
enrolled at least half-time in a degree or certificate program between 7/1/20-6/30/21, include the name of the school they will be attending.
Independent students: List the people in your household, excluding foster children. Include yourself, your spouse if married, your children and
other people if you will provide more than half of their support between 7/1/20-6/30/21. If anyone will be enrolled at least half-time in a degree or
certificate program between 7/1/20-6/30/21, include the name of the school they will be attending.
If more space is needed, continue this table on a separate page with the student's name and LCCC student ID # at the top.
Full Name
Age Relationship to Student Name of College/University in 2020-21
Self Lorain County Community College
Section F: Certification
Each person signing this worksheet certifies that all of the information reported on it is complete and accurate. Warning: If you purposely give false
or misleading information on this form, you may be fined, sentenced to jail, or both. Electronic signatures will not be accepted.
Student signature: Date:
Parent signature: Date:
(dependent students only)
When all required documents have been gathered, you may submit your information by: a) mail to the address below; b) fax to 440-366-4634 or; c)
deliver to Financial Services, First Floor, Bass Library. Please note: Your request may not be approved nor result in an increase of your financial aid
eligibility. You will be notified of the result of your request via email sent to your official LCCC email address. Watch for two-sided documents. Be
sure to include both sides when faxing. Do not email any documents with personally identifiable information. Incomplete submissions will cause
a processing delay.
Allow at least two-three weeks for review after submitting. If anything additional is needed from you, you will be notified via email sent to your
official LCCC email address.
Please note: Completion/submission of this form does not guarantee an adjustment of your financial aid. You will be notified of the result of your
request via email sent to your official LCCC email address. All decisions are final and cannot be appealed to the U.S. Department of Education.
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Special Circumstance Review Request 2020-21 Financial Aid Year (Lorain County Community College)

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Completed 26 July 2020

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