Dependency Documentation form.pub

Session: 2161
Track Code: OE
SOCIAL SECURITY NUMBER
MPC STUDENT’S ID NUMBER
Use ink only.
2016—2017 Dependency Documentation Form
_______________________________________________________
Last Name
First Name
_____________________________________________
Social Security Number / MPC Student ID Number
On the FAFSA you indicated that you are an orphan/ward of the court (or were a ward of the court until age 18), an emancipated
minor, in a legal guardianship, homeless youth, or a veteran of the U.S. Armed Forces. Please complete this form by checking the
box that best describes your situation and attach the documentation requested below to verify your status. Follow the directions
carefully.
I am an orphan (check this box only if both parents are deceased; do not check this box if one parent is deceased and the
whereabouts of your other parent is unknown).
Attach a copy of your birth certificate, along with a copy of each parent’s death certificate.
I am a ward or dependent of the court, or I was a ward or dependent of the court until the age of 18.
Attach a letter from your social worker confirming that your were a dependent of the court until the age of 18, or a letter
stating that you are a participant in the Independent Living Skills Program (ILSP), or other court documentation showing
that you were removed from your home because it posed a direct threat to your well being.
I was convicted of a crime as a juvenile and became a ward of the court through the California probation system as a
result. You do not meet the definition of “ward of the court” for financial aid purposes because the State of California uses
this term differently than other states (see FAFSA instruction at www.fafsa.ed.gov for clarification). You will need to check
your Student Aid Report (SAR) to be sure a parent signature and parental information in questions 59-94 is provided.
I am an emancipated minor/legal guardianship. Attach a copy of the court’s decision (from your state of legal
residence) that your are an emancipated minor/legal guardianship.
Unaccompanied homeless youth. Attach documentation from a school district’s homeless liaison, a director (or
designee) of an emergency shelter program funded by the Department of Housing and Urban Development (HUD) or a
director (or designee) of a runaway or homeless youth basic center or transitional living program as of the day you signed
the FAFSA.
I am a Veteran of the U.S. Armed Forces. Attach a copy of your DD214 stating honorable discharge or discharge other
than dishonorable if you are a veteran of the U.S. Armed Forces.
I made an error on my FAFSA. I am not an orphan/ward of the court, emancipated minor, unaccompanied homeless
youth, or a veteran of the U.S. Armed Forces. You will need to make a correction to your FAFSA reflecting a parent signature and parental information in questions 59-94. Failure to correct your FAFSA will result in a delay of your Financial Aid
award.
Student Certification
I hereby declare that all information reported on this document is true, complete and accurate to the best of my knowledge. I understand
that any false statement or misrepresentation will be cause for denial, reduction, withdrawal and/or repayment of financial aid.
Student Signature:_________________________________________
Date:____________________
MPC Student Financial Services, 980 Fremont Street, Monterey, CA 93940
Phone: 831-646-4030
Fax: 831-646-4202 E-mail: [email protected]
Website: www.mpc.edu Federal School Code #001242