Rose State College > Affordability > Financial Aid > Financial Aid Forms > Dependent Student – Special Circumstances Request

Dependent Student – Special Circumstances Request

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Student’s Name:*

First Last

RSC Student ID#:*

Email*

Your financial aid eligibility is determined according to procedures established by the federal government. These procedures require that each student undergo a consistent evaluation of the family's ability to pay the direct costs of attending school.

Based on this evaluation of your ability to pay for school and an estimate of your cost of attendance, we offer you a package of financial aid to help you meet the costs you are not able to meet.

In establishing these procedures, the federal government has acknowledged that some students will have special circumstances affecting their ability to pay for school. As a result, the government does give financial aid administrators limited authority to make adjustments to financial aid eligibility.

Federal regulations governing the student financial aid programs allow for the re-calculation of eligibility if the student’s parent(s) have encountered significant financial changes between the 2022 income reported on the 2024-2025 FAFSA and the current academic year. This comparison will allow the RSC Financial Aid Office to determine if your family’s resources have decreased significantly during the 2024-2025 academic year.

All students requesting a special circumstances review will automatically be selected by the RSC Financial Aid Office for verification of certain information reported on the student’s FAFSA. In addition to the documents required to verify your parent’s special circumstance, dependent students will also be required to submit the following documents.

if filed, a copy of your 2022 IRS Tax Return Transcript or signed paper copy of your 2022 personal IRS federal tax return

a copy of your parent’s 2022 IRS Tax Return Transcript or a signed paper copy of your parent(s)' 2022 personal IRS federal tax return

a copy of you and your parent(s)' 2022 IRS W-2 Forms(s)

2024-2025 Dependent Verification Worksheet www.rose.edu/financial-aid-forms

The student and parent must complete all sections of this form:

Section I –Special Circumstance

Section II- Parent’s Current Income Worksheet

Section III-Other Information

Section IV-Student and Parent Certification
REQUESTS SUBMITTED WITHOUT DOCUMENTATION WILL NOT BE PROCESSED.
THE DECISION RENDERED BY THE RSC FINANCIAL AID OFFICE IS FINAL AND CANNOT BE APPEALED.

YOUR FAMILY CONTRIBUTION

The RSC Financial Aid Office uses a federal formula to calculate your Expected Family Contribution (EFC). The EFC is based on the notion that each student (and his or her family) has the primary responsibility of providing for the cost of attending college to the extent that they are financially able. Sometimes a family's financial situation changes and the information used to calculate your EFC is no longer realistic. Situations that may qualify for an EFC adjustment may include, but are not limited to, the reasons listed below.

Please choose your parent’s special circumstance from Section I.

SECTION I – SPECIAL CIRCUMSTANCE

(Your parents must also complete SECTIONS II, III and IV of this form)

A – DISABILITY

If this circumstance applies, when did the disability begin?

If this circumstance applies, when did your parent’s employment stop?

You must submit a letter on letterhead that describes your parent’s disability. The letter should be prepared by a physician or health agency and should address your parent’s employability.

Max. file size: 50 MB.

B – UNEMPLOYMENT

1. Submit a statement from your parent’s employer(s) that verifies the date the parent’s full-time employment ended. If this is not available, submit a notarized statement that verifies your parent’s last date of full-time employment.

2. Submit your parent’s last pay stub(s) for the job(s) that ended.

File

Max. file size: 50 MB.

C – DIVORCE, LEGAL SEPARATION or DEATH of a PARENT

If applicable, what was the date of your parents’ divorce or legal separation?

If this item applies, you must submit a copy of your parents’ divorce decree or documentation of legal separation.

Max. file size: 50 MB.

List the current members of your parent’s household, including yourself:

Name

Relationship to Applicant

Age

D – LOSS of OTHER RESOURCES

Type of Income

Last Date Received:

To verify this item, you should submit a statement which verifies the total amount of the indicated income received for 2022. The statement should verify the last date the resource was received by your parent. This should normally be verified on agency letterhead.

File

Max. file size: 50 MB.

SECTION II PARENT CURRENT INCOME WORKSHEET

This section must be completed in all cases. You must submit documentation to verify ALL sources of income your parent(s)are currently receiving as of the date this form is submitted.

Type Of Income

Wages/Salary/Tips

Dates Resources Received