Complete the requested information


2014-2015 Non-Traditional Household
** A non-traditional household consists of the student, his/her parents, and individuals such as siblings of the student born before January 1, 1991, grandparents, niece, uncle, cousin, etc. may be listed in Section B of your Verification Worksheet.** NOTE: Foster child/children may not be counted.

Additional Information Request Form
According to our records, your 2014-2015 Free Application for Federal Student Aid (FAFSA) was selected for a process called “Verification.” Based on data reported in the FAMILY INFORMATION section (“B”) of your Verification Worksheet, you listed a “non-traditional” person(s) as part of the household. In order to determine your financial aid eligibility, we need additional information to complete the verification process.
Please complete, along with your parent(s), the reverse side of this form. Information must be provided to our office about the persons in the household, including the non-traditional individual(s) whom your parent(s) are supporting. Also, documentation must be provided as evidence of any source of income from work and/or income from any outside agency, such as; 1099 Statement, W-2’s, AFDC, ADC, Social Security Benefits, etc…received in year 2013. Documentation can include, but are not limited to, 2013 Federal Tax Returns, W-2’s, Form 1099 (SSI), Eligibility Letter/Statement, etc.

  Student Information

  Income and Expenses

You the Student

Student's Parent / Spouse

Non-Traditional Person


By checking this box, you certify that all the information reported on this form is complete and correct.

  Non-Traditional Certification Section

Person(s) living in your household considered as non-traditional (above 18 years of age) must submit a WAGE Record File/Benefits History of their State of Residency AND complete the certification section below:

I attest that the person named above provides more than half of my support and will continue providing more than half of my support from July 1, 2014 through June 30, 2015.

If there is more than one non-traditional person in the household, please fill in a separate form with additional certification(s).