Low Income Form - Office Of Student Financial Assistance - 2018-2019
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12018-2019
Office of Student Financial Assistance
LOW INCOME FORM
INDEPENDENT
Student’s Name:______________________________
UCF ID:___________________________
Spouse’s Name:______________________________
Date: _____________________________
Dear Student:
The income you reported on your 2018-2019 FAFSA appears insufficient to support the number of people in the household. Please
complete this form to clarify how you were able to live and support your household during the year 2016. Use and attach a second
sheet of paper if necessary.
Annual
Annual
2016 Total Income:
Student Income
Spouse Income
Income from employment
Unemployment Benefits
Child Support Received
Social Security Benefits
Educational VA Benefits
Non-educational VA Benefits
Financial Aid (Grants, Scholarships, Loans, etc.)
Money spent from savings
Personal loans or credit card charges
Other
XXXXXXXXXXXX
XXXXXXXXXXX
Food Assistance
Yes-
No-
XXXXXXXXXXXX
XXXXXXXXXXX
Housing Assistance
Yes-
No-
Cash support for expenses* paid by parents, grandparents or others
*
Expenses include but are not limited to mobile phone, auto & health insurance, recreation, meals, personal bills, etc.
TOTAL
$
$
Who Pays
2016 Total Expenses:
Annual Expenses
for/Provides
$
Housing: Living with parents Yes-
No-
$
Utilities
$
Food
$
Clothing
$
Transportation (car, insurance, gas, etc.)
$
Medical
$
Personal
TOTAL $
1) If the total expenses are more than the total 2016 income, please explain how the living expenses were paid:
2) If the living expenses equal “0”, you must explain how you lived with no expenses:
3) Please explain briefly how your family is currently meeting its financial obligations:
Student’s Signature
Date
Spouse’s Signature
Date
Office of Student Financial Assistance • Millican Hall, Room 107 • Orlando, FL 32816-0113
LINC _Indep_1819-Rev.11/17
Phone: 407.823.2827 • Fax: 407.823.5241 • Web: finaid.ucf.edu | a division of Student Development and Enrollment Services
An Equal Opportunity and Affirmative Action Institution
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