Financial Aid

Unusual Circumstance Form - 2006-2007

University of Wisconsin - Stevens Point Unusual Circumstance(s) Form for the 2006-2007 Aid Application Year.

Your 2005 tax returns and 2006-07 FAFSA must be completed prior to submitting an Unusual Circumstance(s) Form.(Be sure to keep all narratives within the left and right margins of the space provided; you may scroll downward as far as is needed)

Identification:

Your (student's) Name:

Your (student's) Birthdate:

(MM/DD/YYYY)

Your Student ID Number:

1. SPECIAL EXPENSE SITUATION (check only if appropriate):

Substantial elementary or high school education tuition expected 7/1/2006 - 6/30/2007
Amount to be paid: $
Who creates this expense:	Brother Sister Your child

Substantial medical/dental expenses expected 7/1/2006 - 6/30/2007:
Amount you will pay yourself (not with insurance): $
Who pays this expense?	Parent Student Student's Spouse
Describe illness (keep content within left and right within margins):


Tuition payments for parents attending college/university 7/1/2006 - 6/30/2007: $
Name of parent's college or university:

UNLESS YOU ALSO HAVE AN INCOME LOSS, YOU MAY SKIP SECTION 2.

2. LOSS OF INCOME SITUATION (Check only if appropriate):

Who has suffered a loss of income?	Father Mother Student Spouse
What is the unusual circumstance?
Wage earner is ill:	Dates of illness:
	from to
Describe illness (keep content within left and right margins):


Wage earner has died:	Date of death:

Family member has lost or will lose benefits:
What benefit is affected?
Date benefits terminated:

Wage earner has lost job:
When was last day of work?
Has new job been found?	No Yes
Yes - start date:

Income has been reduced for other reason
When did reduction take effect?
Reason for reduction (keep content within left and right margins):


Family member divorced or separated since FAFSA filed
Date of divorce or separation:

Dependent student only - with which parent will you now live (show only this parent's income below)?
Mother Father

INCOME INFORMATION FOR CALENDAR YEAR

(provide expected 2006 gross income for all applicable family members; this is Jan. 1 - Dec 31)

	Father	Mother	Student	Spouse

2006 wage income:	$	$	$	$
2006 other taxable income:	$	$	$	$
2006 untaxed income:	$	$	$	$

Sometimes it is more appropriate to use a twelve month period that more closely approximates the academic year calendar-- we call this an award year. If this is appropriate in your situation, we may base our reanalysis upon this information instead of the calendar year information. Please provide both sets of income information.

INCOME INFORMATION FOR AWARD YEAR

(provide expected gross income for 2006-2007 period-- 6/1/2006 to 5/31/2007 for all applicable family members)

	Father	Mother	Student	Spouse

2006-2007 wage income:	$	$	$	$
2006-2007 other taxable income:	$	$	$	$
2006-2007 untaxed income:	$	$	$	$

3. CERTIFICATION

(transmission of data by student under personal password represents that all data submitted is authorized as stated. Parental data may not be submitted unless authorized by student's parent. The Financial Aid Office may corroborate data submitted through telephone contact with parents).

This section may be omitted if student is classified as an independent student, but it must be completed if student is a dependent student.

Parent(s) contact information:

Father's Name:	Phone:
Mother's Name:	Phone:

Daytime phone number of person completing this form:

Name of person completing this form:

E-mail address of person completing this form:

Student's E-mail address:

4. Additional Narrative:

Provide any additional narrative that you feel will help us understand your situation. (Be sure to keep content within left and right margins; you may scroll downward as far as is needed.)

5. Transmit Information

If all information entered above is accurate (and any parental information is authorized by parent), you may transmit it to the Financial Aid Office at UW-Stevens Point at this time. You may expect to be notified of any action taken within a few weeks.