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2018-2019 Special Circumstance Review Application

FAMU IS AN EQUAL OPPORTUNITY/EQUAL ACCESS UNIVERSITY DIVISION OF STUDENT AFFAIRS TELEPHONE: (850) 599-3730 OFFICE OF FINANCIAL AID FAX: (850) 561-2730 EMAIL: 2018-2019 Special Circumstance Review Application All applicants are required to complete this section. (The Application will be returned if all applicable pages are not completed and submitted.) This Application should be used AFTER the 2018-2019 Free Application for Federal Student Aid (FAFSA) has been submitted. Complete this form ONLY if there has been recent unusual or extenuating circumstances, which have caused a significant decrease in your 2016 taxable or non-taxable income. Each request for a Special Circumstance Review is evaluated on an individual basis. In order to have your award re-evaluated; your initial award must be processed first.

FAMU IS AN EQUAL OPPORTUNITY/EQUAL ACCESS UNIVERSITY 1. How much did you/your parent(s) /spouse pay for medical/dental insurance in 2016? (Do not include employer’s contribution.) $ _____

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