Proof Of Separation Form 2013-2014 printable pdf download

444 Western Boulevard

Jacksonville, North Carolina 28546-6816

Phone (910) 455-1221

PROOF OF SEPARATION FORM

2013-2014

STUDENT NAME__________________________________________ CCCC ID#__________________

According to your 2013-2014 Free Application for Federal Student Aid (FAFSA), you (or your parent)

indicated your marital status was “separated/divorced”. Before your eligibility for federal and state financial

assistance can be determined, this form must be completed and returned with all required documents.

If you do not provide the necessary documents, you will be required to provide your spouse’s information.

STEP 1: Complete the following information about your marriage.

This form is submitted to document the separation of the: Student/Spouse ______

Parent/Spouse ______

Date of Marriage: _________________ (MM/DD/YY) _________________Date of Separation: (MM/DD/YY)

Do you intend to proceed with a divorce? Yes_____

No_____

Have you consulted with an attorney or legal aid about your separation? Yes_____

No_____

Provide a copy of a letter from your attorney or legal aid office representing you. The letter must be on

official letterhead, and include the full name, complete address and phone number.

Do you have a court appearance date for the divorce proceedings? Yes_____

No_____

If yes, when? ____________

What was the last year a joint federal tax return was filed? __________ -OR- We never filed a joint return.

STEP 2: Complete the following information about your household.

Date on which you and your spouse changed residences? ___________________________________________

Name of Student or Parent completing this form: __________________________________________________

Complete Physical Address: __________________________________________________________________

Home Telephone Number: _________________________ Cellular phone Number: ______________________

Who pays the rent/mortgage and utilities for this residence? _________________________________________

Provide copy of lease or mortgage agreement.

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Proof Of Separation Form 2013-2014