Averett University 2015-2016
SpecialCircumstance/Professional JudgmentForm
StudentName: _Student ID: P000
Student Address:
Home Phone #:CellPhone #:Email:
TheAverettUniversityStudent FinancialServicesOfficeunderstandsthatfinancinga Universityeducationisasignificantlifeinvestment families canmake.Wearecommittedtoofferingahigh-qualityeducationandwilldoeverythingpossibletoensurethatyouandyourfamily canaffordAverettUniversity.Asa result,ifyourfamily’sfinancialsituationhaschangedsinceyoufiledthe2014-2015Free ApplicationforFederalStudentAid (FAFSA),oryourfamilyhasspecialcircumstancesaffectingyourabilitytopaywhicharenot capturedontheFAFSA,youmayqualifytohaveyourfinancialaideligibilityre-evaluated.Pleasefollowthe stepsbelowtoensure atimelyre-evaluationofyourfile:
STEP1: VERIFICATIONPROCESS
AverettUniversitypolicyrequiresthatallfinancialaidapplicantsrequestinganadditionalreviewoftheirfinancialaid packagedue to specialcircumstancesmustfirstparticipateintheverificationprocess.Tocompletethisprocessyoumustsupplythefollowing itemsforreview:
- Completedverificationworksheet
- Copyofyour(and if applicable spouse or significant other)2014IRS TaxReturn TranscriptW-2’s
- Copyof yourparent’s2014IRSTaxReturnTranscriptW-2’s(if youareadependentstudent)
Alldocumentsmaybemailed totheattention of the StudentFinancial Services Officeat420 West Main Street, Danville, VA 24541. They may also be faxed to (434)791-5647. Pleasenote, however,thatuponreview,itispossiblewemayrequestadditionaldocumentationregarding verification.
STEP2:IDENTIFICATION OFSPECIAL CIRUMSTANCES
AverettUniversitywillreviewallspecialcircumstancesonanindividualbasisandwillmakea determinationasquicklyaspossible. Foryourconvenienceinexplainingyoursituation,belowaresometypicalspecialcircumstancecategoriesthatourofficehas consideredinthepast.Pleasereviewthislistand checktheappropriatereason(s)foryourrequest.Weaskthatyoucompletethis stepinfull,payingparticularattentiontotherequesteddocumentation.Failureto supplyALLofthe requesteddocumentationwill resultina processingdelay.
REQUIRED FOR ALL APPLICATIONS:
Detailed statement of circumstances that caused change to family financial situation that includes student’s name and Averett ID #.
Unemployment:Unemploymentmusthaveoccurredatleast10weekspriortothesubmissionofthisformandresultedinalossofatleast20%ofincome.
The unemployment is for: Relationship to Student
Name of former employer(s)
Requireddocumentation:
a)Signedletter fromemployer oncompanyletterheadverifyingseparationfromemployment,the lettermust include the dateofhire and dateofseparation.Ifyou oryourfamilymembers havebeenseparatedfrom more than one employer,youmust submita letterofseparationforeachemployer.
b)Anitemizedlist ofyourfamily’sestimated 2015income fromallsourcesandestimated 2015federalincome taxtobe paid. Be sure toinclude anywages earnedtodate aswellas unemploymentwages,compensation packages, childsupport,social security benefits, untaxedincome,etc.
Divorce/SeparationaftertheFAFSAhasbeenfiled:
Requireddocumentation:
a)Copyoflegaldivorce decree or documentationof separation.
b) Copyof Divorced/Separated persons’2014FederalIncomeTaxReturnW-2’s if filed joint tax return.
c)Letteraddressingseparation ofincome andassets reported ontheFAFSA
Changeinemployment/Reductionof Income:Changesinemploymentmusthaveoccurredatleast10weekspriortothe submissionofthisformandresultedinalossofatleast20%ofincome.
The change in employment is for: Relationship to Student
Name of employer(s)
Requireddocumentation:
a)Statement from employeron company letterhead that includes reduction of hours, if reduction permanent or temporary, effective start date of reduction or temporary status.
b)Anitemizedlist ofyourfamily’sestimated 2015income fromallsourcesandestimated 2015federalincome taxtobe paid. Be sure toinclude anywages earnedtodateas wellas unemploymentwages,compensation packages, childsupport,social security benefits, untaxedincome,etc.
Deathofa familymemberaftertheFAFSAhasbeenfiled:
Relationship offamilymembertostudent:
Requireddocumentation:
a)Copyofdeathcertificate
b)Anitemizedlist ofyourfamily’sestimated 2015income fromallsourcesandestimated 2015federalincome taxtobe paid. Be sure toinclude anywages earnedtodate, social security benefits, untaxedincome,etc.FA office may need copy of Deceased family member’s Federal Income Tax return and W-2’s to adjust total income for 2015.
Step 3: AlldocumentsmaybemailedtotheattentionoftheStudent FinancialServices Officeat
420West Main Street,Danville,VA24541; orfaxedto (434)791-5647; or scanned and emailed
to your Financial Aid Counselor.
Allrequesteddocumentationmustbereceivedandtheverificationprocess mustbecompleted beforea reviewof yourfinancialaidpackagewillbeconducted.Submittingthisformalongwiththeappropriatetaxreturnsand supportingdocumentationmayormaynotresultinanincreaseinyourfinancialaideligibility.If youhavefurtherquestionsabout thisformoryourfinancialaidpackage,pleasecontacttheStudent FinancialServicesOfficeat (434)791-5600or (800)283-7388.
I certify that the above and attached information is complete and accurate to the best of my knowledge.
All parties whose information is included on this form must sign below
Student’s Print Name Student’s Signature Date
Parent’s Print Name Parent’s SignatureDate
Academic Year: ___ Averett Official Use Only
PJ ApprovalPJDeniedNeed Additional Information
Student Financial Services CounselorDate
______
Student Financial Services CounselorDate
______
Student Financial Services CounselorDate
AU Student Financial Services • 420 West Main St., Danville VA 24541 • 1-800-283-7388 • Fax: 434-791-5647 •