Student Contribution Adjustment Request Lander University by liaoqinmei

VIEWS: 1 PAGES: 5

									                                                                                                                                             13SCAR

                                               Lander University Financial Aid Office
                                                         320 Stanley Avenue, Greenwood, SC 29649
                                                   Email: finaid@lander.edu  Web: www.lander.edu/finaid
                                                        Phone: (864) 388-8340  Fax: (864) 388-8811



                                            2012-2013 Student Contribution Adjustment Request
Complete this form if you feel your family has special circumstances that should be considered with your application for financial aid. Attach a letter of explanation and
appropriate documentation (see back) for the circumstance(s) you wish to have considered. All sections below must be completed and the form must be signed in order for
the request to be reviewed. If you have a special circumstance that you feel warrants a review but that is not listed below, please speak with a counselor in the Office of
Financial Aid for additional instructions.

     ___________________________________________________________________________________________
     Student's Last Name, First, M.I.                                                                          Lander ID (L#)

     ______________________________________________________________________________________________________
     Local Address                                                                Local Phone Number
Circumstances and documentation:
Your request for an adjustment must be accompanied by the following:
         You must have submitted your 2012-2013 Free Application for Federal Student Aid (FAFSA) at www.fafsa.gov.
         A letter of explanation explaining clearly the circumstance(s) surrounding the request; AND
         2012-2013 Verification Form, if not already submitted (copy available at end of form or at http://www.lander.edu/en/Academics/Financial-Aid/Forms.aspx); AND
         Parents’ Signed 2011 Federal Tax Returns and all schedules and W-2s; AND the 2011 IRS Tax Transcript available at www.irs.gov
         Student’s Signed 2011 Federal Tax Returns and all schedules and W-2s; AND the 2011 IRS Tax Transcript available at www.irs.gov
         Appropriate documentation from the chart below:
Circle
                                               Circumstance                                                             Documentation Needed
 one
1
         Spouse, whose income was included on the applications, has died.                                  Copy of death certificate.

2                                                                                                          Letter from employer documenting last day of
         Student or spouse has experienced a loss of employment resulting in a                              employment
         significant decrease in income for the 2012 tax year compared to the 2011 tax                     Copy of last pay stub
         year (January 1-December 31).                                                                     Documentation of severance pay, vacation pay,
                                                                                                            unemployment, retirement or disability benefits
         Date Change Occurred: __________________________________________                                   to be received for 2012, if applicable
                                                                                                           Statement from Employment Security Commission
                                                                                                            confirming unemployment eligibility
                                                                                                           Projected 2012 Income Statement
3                                                                                                           Letter from employer documenting change in
         Student or spouse has experienced a change in employment resulting in a                            employment
         significant decrease in income for the 2012 tax year compared to the 2011 tax                     Copy of last pay stub from prior job
         year (January 1-December 31).                                                                     Copy of last 3 pay stubs from new job
                                                                                                           Statement from Employment Security Commission
         Date Change Occurred: ____________________________________________                                 confirming unemployment eligibility
                                                                                                           Projected 2012 Income Statement
4
         Student or spouse received unemployment compensation or some type of
         untaxed income or benefit (i.e., child support) in the last calendar year but has
                                                                                                           Letter from the benefit agency documenting that
         completely lost this income or benefit. The untaxed income or benefit must be
                                                                                                            benefit has ceased.
         from a public or private agency, a company, or because of a court order.

5                                                                                                          Documentation of type, source, and date of lump-
         Student or spouse received a one-time lump sum distribution.
                                                                                                            sum distribution.
6
                                                                                                           Medical bills or account statements showing
         The family has paid unusual medical, dental, or nursing home expenses, not
                                                                                                            medical expenses paid (OR 2011 Schedule A
         covered by insurance.
                                                                                                            showing medical expenses). Expenses covered by
                                                                                                            insurance will not be considered.
7
         Students’ taxable income increased due to a fund transfer from a regular IRA
                                                                                                           Documentation that funds were transferred from
         account to a Roth IRA account.
                                                                                                            a regular IRA to a Roth IRA.
8                                                                                                          Letter or bill from school documenting amount of
         The family has paid elementary and/or secondary school tuition for dependents.
                                                                                                            tuition paid for 2011.
9                                                                                                          Letter or bills documenting amount and type of
         Student paid dependent care expenses not covered by another source.
                                                                                                            expenses paid for 2011.
      Projected 2012 Income Statement

      1. Identify the reason (from front of this sheet) that a review is requested: _________________________________________________

      2. Identify any taxable income the student expects to receive 01-01-12 through 12-31-12:

                A. Wages, Salaries, Tips:                  Student $____________________ Spouse $_______________________
                (Refer to worksheet below)

                B. Taxable portion: Pensions and/or Annuities:                       $_______________________

                C. Interest/Dividend Income:                                         $_______________________

                D. Rental Income, Alimony, or Other Income                           $_______________________

      3. Identify any untaxed Income the student and/or spouse expects to receive 01-01-12 through 12-31-12:

                A. VA Non-Educational Benefits                                                 $_______________________

                B. Unemployment or Welfare/AFDC Benefits                             $_______________________

                C. Child Support                                                               $_______________________

                D. Untaxed portion: Pensions and/or Annuities:                       $_______________________

                E. Military or Clergy Housing/Food Allowance                         $_______________________

                F. Any Other Untaxed Income:                                                   $_______________________


      I declare that the information reported on this document is true and accurate, and I understand that the Office of Financial Aid reserves
      the right to deny a possible adjustment when sound documentation is not provided. I understand that Lander University may verify all
      estimates of income at year end. Adjustments may be made to current or future financial aid if inaccurate estimates of income result in
      a financial aid overaward.

                Student Signature: ___________________________________________________________ Date: ___________

                Spouse Signature: ____________________________________________________________Date: ___________

             Worksheet for Estimating 2012 Wages, Salaries, Tips for the Student/Spouse Experiencing Loss of or Change in Employment
      1. What are the year-to-date earnings on your final 2012 pay stub for former position?
      (Please attach copy of pay stub.) Last date of employment:_________________
      2. What is the amount you are receiving per month for your new position, if
      now employed? (Please include a copy of your last 2 pay stubs documenting
      your monthly salary.)
       Start date for new position, if applicable:____________________
      3. Number of Months you will receive this income between 1/1/12 and
      12/31/12.
      4. Total anticipated earnings from new position (Item #2 multiplied by Item #3)
      5. Total Anticipated Income for 2012 (include in Box a. on Projected Year Income Statement)




      DATA ENTRY                                                              COUNSELOR REVIEW
RRAAREQ                  N=Pending Review      Review SCAR instructions for all required docs. If not collected, note why.
Initials/date                                  FAO Counselor/Committee Decision (circle)                                            Approved      Denied
                                               Verification Completed and RNAVRxx updated (Note on Verf Review Wksht
Fwd to Counselor date
                                               adjustments and attach PCAR)
                                               RNANAxx/Information Release tab – PJ Used = YES
                                               Recalc Need, update ROAUSDF efc and trans #, update RPAAWRD aid
                                               RRAAREQ – 13SCAR + add CORRP for correction
                                               RHACOMM
                                               Add to Excel for PJs and mail merge appropriate ltr based on whether ISIR rec’d or
                                               paper FAFSA coded
                                               CNSLR Initials and date
                                   Lander University Financial Aid Office                                              13VERF
                                             320 Stanley Avenue, Greenwood, SC 29649
                                       Email: finaid@lander.edu  Web: www.lander.edu/finaid
                                            Phone: (864) 388-8340  Fax: (864) 388-8811


                                           2012-2013 Verification Worksheet


     Student’s Last Name                    First                   MI                                    Lander ID (L#)

     Student’s Phone #__________________________________ Parent’s Phone #____________________________________

Your application for federal student aid was selected for a review process called “verification.” In this process, federal law requires
the school to collect additional documents to confirm the accuracy of the information reported on the student’s Free Application for
Federal Student Aid (FAFSA). After all documents are received, the information will be reviewed for accuracy. If necessary, the
information will be corrected on the FAFSA and aid packages adjusted accordingly.

You must return this completed form as well as all required financial documents to the Financial Aid Office within 15 days after
receiving this notification to avoid delays in processing. Awards made prior to completion of verification are estimates only
and are subject to change. Additional information may be requested to resolve any conflicting information.

For additional explanations for FAFSA verification questions, review your FAFSA at www.fafsa.gov and refer to the instructions for
completing the FAFSA at http://studentaid.ed.gov/students/attachments/siteresources/2012-13CTF.pdf.) If your answers differ from
your original answers on the FAFSA, include a note of explanation.


Section A: Student Status
  FAFSA
QUESTION#
                               DEPENDENCY QUESTIONS (Please check the box for YES or NO)                                   YES      NO
    45         Were you born before January 1, 1989?
    46         As of today, are you married? (Also answer “Yes” if you are separated but not divorced.)
               At the beginning of the 2012–2013 school year, will you be working on a master’s or doctorate
    47
               program (such as an MA, MBA, MD, JD, PhD, EdD, graduate certificate, etc.)?
    48         Are you currently serving on active duty in the U.S. Armed Forces for purposes other than training?
    49         Are you a veteran of the U.S. Armed Forces?
               Do you have children who will receive more than half of their support from you between July 1,
    50
               2012 and June 30, 2013?
               Do you have dependents (other than your children or spouse) who live with you and who receive
    51
               more than half of their support from you, now and through June 30, 2013?
               At any time since you turned age 13, were both your parents deceased, were you in foster care or
    52
               were you a dependent or ward of the court?
    53         As determined by a court in your state of legal residence, are you or were you an emancipated minor?
    54         As determined by a court in your state of legal residence, are you or were you in legal guardianship?
               At any time on or after July 1, 2011, did your high school or school district homeless liaison determine
    55
               that you were an unaccompanied youth who was homeless?
               At any time on or after July 1, 2011, did the director of an emergency shelter or transitional housing
    56         program funded by the U.S. Department of Housing and Urban Development determine that you were
               an unaccompanied youth who was homeless?
               At any time on or after July 1, 2011, did the director of a runaway or homeless youth basic center or
    57         transitional living program determine that you were an unaccompanied youth who was homeless or
               were self-supporting and at risk of being homeless?

              If you, the student, answered “NO” to all of the above questions, you are considered a dependent student
               for federal financial aid purposes and must provide your parents’ information and tax forms as well as your
               own.
              If you answered “YES” to any of the above questions, you are considered an independent student and
               only need to provide your information and tax returns (as well as your spouse’s, if married).

     Note: Grandparents, foster parents, legal guardians or those with legal custody are NOT
     considered parents (unless they legally adopted you) for FAFSA purposes and their
     information cannot be used.
                               Financial Aid Office Use
           DATA ENTRY                                                     COUNSELOR REVIEW
                                         Only
 RRAAREQ                             N=Pending Review         Complete Verf Review form
 Initials/date                                                CNSLR Initials/date
 Fwd to Counselor date
 Section B: Household Information
Instructions for Whom to Include in Household Information
         Dependent Students:

         If you are required to provide your parent’s information according to the instructions in Section A, you must
         include the following:

                    Yourself and your parent(s) (include stepparent) NOTE: To determine who is considered a parent for
                   purposes of this form, refer to http://studentaid.ed.gov/students/attachments/siteresources/2012-
                   13CTF.pdf.
                    Your parent’s other children if
                                  o (a) your parents will provide more than half of their support from 7-1-2012 through 6-
                                       30-2013 OR
                                  o (b) the children could answer “NO” to every question in Section A,
                    Other people if they now live with your parents and your parents provide more than half of their support,
                   and will continue to provide more than half of their support from 7-1-2012 through 6-30-2013.

         Independent Students:

         If you are not required to provide your parent’s information according to the instructions in Section A, you
         must include the following:

                    Yourself and your spouse (if married),
                    Your children, if you will provide more than half of their support from 7-1-2012 through 6-30-2013,
                    Other people if they now live with you and you provide more than half of their support, and will
                   continue to provide more than half of their support from 7-1-2012 through 6-30-2013.

                                                    (Attach separate page if more space is needed.)

                                                                                                      Name of College if this family member
                                                                                                      will be enrolled for 2012-2013 at least
                            Name of                       Social Security   Relationship to
                                                                                                      half-time in a program that leads to a
                      Household Members                      Number            Student
                                                                                                      college degree or certificate. Do not
                                                                                                      list a college for your parent(s).
                                                                                              Age
     1                                                                          SELF                  LANDER UNIVERSITY
     2
     3
     4
     5




Section C: Additional Financial Information
                    SNAP: Did any of the persons listed in Section B of this worksheet receive benefits from the Supplemental
                     Nutrition Assistance Program or SNAP (formerly known as food stamps) any time during the 2010 or 2011
                     calendar years? Check one below:
                                       ____Yes         ____No

                    Child Support Paid: Child support paid by the parent(s) listed above (or for the independent student,
                     by the student/spouse) because of divorce or separation or as a result of a legal requirement. Don’t include
                     support for children listed in your household above. Report TOTAL paid for each child in 2011, not monthly
                     amounts. Please complete details below. (Attach a separate page if more space is needed.)
                                                                                       Amount of
                                                                                         Child
           Name of Person Who Paid Child            Name of Person to Whom Child                       Name of Child for Whom Support was
                                                                                        Support
                      Support                            Support was Paid                                              Paid
                                                                                        Paid in
                                                                                         2011
Section D: Tax and Earnings Information
       Parent’s Tax Filing Status (Check a status below and submit documents as requested):

                I/We have filed and have attached a copy of our 2011 Federal Tax Return Transcripts. (See instructions below.)

                I/We did not file and are not required to file a federal tax return for 2011.
                     o Attach all 2011 W-2s.
                     o List names of all employers even if they didn’t issue a W -2 and the amounts earned for the 2011 tax year.
                 Employee                                  Employer’s Name                         2011 Amount Earned         W-2 Issued by Employer?




       Student’s Tax Filing Status (Check a status below):

                I/We have filed and have attached a copy of our 2011 Federal Tax Return Transcripts. (See instructions below.)

                I/We did not file and are not required to file.
                     o Attach all 2011 W-2s.
                     o List names of all employers even if they didn’t issue a W -2 and the amounts earned for the 2011 tax year.
                      Employee                                   Employer’s Name                         2011 Amount Earned        W-2 Issued by Employer?




       Instructions for Receiving a 2011 Federal Tax Return Transcript - NEW FOR 2012-2013: We are now required by the US
       Department of Education to use an IRS Tax Return Transcript and are no longer allowed to accept copies of your or your
       parents’ tax returns. If you filed an amended return, you will also need a Tax Account Transcript for 2011. To request a
       copy:
               On-line
                     1. Go to www.irs.gov
                     2. Under Tools, select Order a Return or Account Transcript
                     3. In the type of transcript, select Tax Return Transcript and 2011 for the Tax Year.
               By Phone
                     1. Call the IRS at 1-800-908-9946
                     2. Follow prompts for tax filer’s Social Security number and numbers in the address on file
                     3. Select Option 2 to request an IRS Tax Return Transcript and 2011 for the Tax Year
               By Paper
                     1. Download paper request form at www.irs.gov/pub/irs-pdf/f4506tez.pdf.



Section E: Signatures
       By signing this worksheet, I/We certify that all of the information reported is complete and accurate.
       (Warning: If you purposely give false or misleading information on this worksheet, you may be fined, be sentenced to jail, or both.)

       ______________________________________ __________________________________________
       Student (Required)             Date           Spouse                          Date
                                                     (Of independent student - optional)
       ______________________________________
       Parent                         Date
       (Required for dependent student)

								
To top