JHU ID#____________
For office use only
BUDGET ADJUSTMENT /
APPLICATION REVIEW FORM
Student Financial Aid Services
Reed Hall- Suite 427
2015-2016
1620 McElderry Street,
Baltimore, MD 21205
410-955-1324 Telephone
410-614-3730 Fax
Email: finaid@jhmi.edu
Complete this form for reevaluation of your financial aid application status or budget adjustment request.
Adjustments to your application does not guarantee immediate award funding. Additional award increases
will be based on remaining federal and institutional budget levels.
(Allow 10 to 15 business days for processing. Students will be notified of status.)
Student Information: (Please Print)
________________________
______________________
________________
Last Name
First Name
SSN/ID
_______________________
___________________
_______________
Primary Phone (home, cell or work)
Email Address
Program
If you hional judgment request, you should contact your t ail:
d.edu pscott@uland.edu tmcmilla@umaryland.edu
Check all that apply. All supporting documentation must be received with before processing will
begin.
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A.________ Income Reduction
An income adjustment due to change in employment will not be processed until after the change in employment has taken place.
When did you/your spouse/your parent(s) change in employment occur? ______________________
Briefly, summarize the circumstances for the change in employment:_______________________________
______________________________________________________________________________________
You are required to submit the following documents with this form to the Student Financial Aid Office:
Signed and dated letter from employer verifying the date of the change in employment – the letter must be
dated after the change in employment
Copy of last pay stub and, if applicable, current pay stub
Any other documentation necessary as requested by the Student Financial Aid Office
B.________ Family Expense
The budget that we assign each student is that of a single independent student with no dependents. If a student has
a family and/or dependents that he/she supports, you are required to submit the following documents with this form to
the Student Financial Aid Office
Daycare expenses (if applicable)
Healthcare expenses not covered by insurance (if applicable)
Other documentation of dependent support you would like to have considered
C.________ Budget Increase (non-family related)
Education related expenses which total more than those allotted in your current student budget (cost of attendance)
or are not reflected in the budget.
D._________ Other
If you feel that your situation may require a review of your financial aid status but does not meet any of the above
criteria, attach a letter of explanation and any supporting documentation
.
Please read and sign below:
I declare the information and documentation I am providing to be true and correct to the best of my
knowledge.
_____________________________
_______________
Student Signature
Date