Noncustodial Parent Waiver Request (Page 2 of 2) in pdf

Noncustodial Parent Waiver Request Page 2

EDIVWR1617

Student Name: _______________________________________

Wheaton ID: ________________________________

(If Known)

Did your noncustodial parent provide child support in 2015? ______ Yes _____ No

If “Yes” indicate the total amount paid for the student: $ _______________

If there are other children, indicate the total amount paid for all children: $ _____________

If “No” indicate the last year that he/she paid any child support: ___________

In the space below or on a separate sheet, please provide a statement from you and your custodial parent explaining why you are

unable to provide the CSS Profile Noncustodial Parent’s Statement. Include any additional information that would help us better

understand the circumstances.

Certification

I certify that the information provided on this form is true and complete to the best of my knowledge.

Student Signature: _______________________________________________

Date: ______________________

Custodial Parent Signature: _______________________________________

Date: ______________________

Please submit waiver request, parent and student statement, and third party letter to:

Wheaton College

Office of Student Financial Services

26 East Main Street

Norton, MA 02766

Phone (508) 286-8232

Fax: (508) 286-3787

Waiver Checklist

Noncustodial Waiver form: ______

Third Party Documentation:______

Parent/Student Statement: _______

Additional Documentation: ______

Noncustodial Parent Waiver Request Page 2