Independent Status Documentation Form - 2017-2018

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2017-2018 INDEPENDENT STATUS DOCUMENTATION FORM
Student Name ________________________________ Student Number ______________________
(please print)
You answered YES to one of the following questions on the 2017-2018 FAFSA making you an
independent student. Before we can continue to process your request for financial aid, please
provide the information:
 If you answered “YES” to the question: “Do you have dependents (other than your children or
spouse) who live with you and who receive more than half of their support from you, now and
through June 30, 2018?” then please complete the additional household information below for the
person(s) you are claiming as your dependent on the 2017-2018 FAFSA:
Relationship
Does dependent(s) receive financial support from another
between you
agency (i.e., Social Security, Child Support, ODJFS, etc.)? If
Full name of dependent(s)
and
yes, please list the name of the agency and amount of monthly
dependent(s)
support received, number of months received, and year
received.
Last Name
First
Yes
No
Agency
Amt. of
No. Of
Year
Name
Monthly
Month(s)
Support
 Number of months you have or will provide support to the above dependent(s) from July 1, 2017 through
June 30, 2018. _______________
 Will any other custodial parent or individual (the child(ren)’s aunt, uncle, or grandparent(s) ) other than
yourself be claiming the above dependent(s) on their 2017-2018 FAFSA? • Yes • No If yes, please
provide the name of the individual. _______________________________________
 If requested, are you able to provide any legal documentation that will show legal relationship towards the
above dependent(s)? • Yes • No

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