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2021-2022 COVID-19 Income Reduction Request
Student First Name
Student Last Name
Student NetID:
Complete the following form if the student and/or spouse/parent has experienced a major change in income due to the COVID-19 pandemic. The request will be evaluated based on expected income during 2020 and/or 2021 including unemployment benefits and any documentation submitted. If your request is approved, the information on the FAFSA will be updated and the Expected Family Contribution (EFC) will be recalculated. Recalculation of the EFC does not guarantee a change to the student’s federal financial aid.
To ensure compliance with federal regulations, there are limits to which circumstances can be considered. Income reductions are considered on a case-by-case basis and must have occurred outside of student/parent control.
Please Note:
Students must complete the 2021-2022 FAFSA at www.fafsa.gov before an Income Reduction Request can be processed.
Families with an EFC of zero will not be reviewed and should not submit an Income Reduction Request.
All verification requirements must be satisfied before your appeal can be considered.
Approval of a request does not guarantee receipt of additional federal financial aid.
A. Special Circumstances for Consideration:
Please submit the following documentation. This form cannot be processed without the required documentation.
Documentation of job loss or reduction in hours or earnings. Acceptable forms of documentation include:
Termination letter or resignation letter for the family member whose employment was impacted
Letter/statement of unemployment benefits
Other documentation of job loss
Add an additional document below.
Add an additional document below.
Add an additional document below.
Add an additional document below.
2019 income verification documents. Acceptable forms of documentation include:
2019 W2
2019 federal tax return
2019 Form 1099
Last 2 paystubs from 2019
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Add an additional document below.
Add an additional document below.
Add an additional document below.
2020 income verification documents. Acceptable forms of documentation include:
Last two pay stubs from 2020
Profit/loss statement for self-employed from January 1, 2020 through date of income loss
Bank statements for self-employed individuals verifying the profit/loss statement by showing income deposits into bank account
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Add an additional document below.
Add an additional document below.
Documentation of Excessive Medical Expenses due to COVID-19:
Excessive Medical Expense Special Circumstances that can be considered: excessive out of pocket medical expenses that exceed 11% of the tax-filer's adjusted gross income (AGI)
Excessive Medical Expense Special Circumstances that cannot be considered: medical expenses paid by insurance or others
Student Signed Statement must include the following: detailed and dated description of the medical situation and the dates/amounts of the out of pocket medical expenses
Future Supporting Documentation Requests may include: only Explanation of Benefits statement (EOBs) from insurance providers detailing out of pocket medical expenses will be accepted
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Add an additional document below.
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B. Projected Income and Benefits
Before we can consider any changes, please complete
this form
and upload below.
C. Explanation of Circumstances
Attach a statement detailing the specifics of your family’s circumstances and provide any pertinent information that will help us better understand your family’s situation. Please submit this form and all supporting documentation
The Financial Aid Office reserves the right to request additional documentation if deemed necessary.
Incomplete appeals will not be processed until all documents have been received.
Completion Checklist:
All documents required in Section A for your parent(s), or spouse are included with this appeal form
Include your name and student ID on all documents
A statement explaining your family’s (if applicable) circumstance is provided
I understand that if the information I provide changes, I must notify the Financial Aid Office immediately and I understand my financial aid award may be revised accordingly. I also understand that approval of this request does not assure approval of a similar future request, and that any financial assistance offered is exclusive to the specific academic year.
By signing this form, I certify that all the information reported is complete and accurate. I understand if I purposely give false or misleading information on this form, I may be fined, sent to prison, or both.
Student Signature (required)
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Parent 2 Signature (if applicable)
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Submit