Dependency Review Form 2016-2017

 

PLEASE PRINT

STUDENT SECTION

Student's name:______________________________________SS#________________

Permanent address:______________________________________________________

Email:__________________________________________________________

1a. student's marital status:________ 1b. date of marital status:___________
2a. student's total earned income 2014: $________; 2015: $_______; est. 2016: $______
2b. student's total other resources 2014: $________; 2015: $_______; est. 2016: $______
3. Was student claimed by parent(s) or legal guardian in: 2014: $________; 2015: $_______; est. 2016: $______


4. Explain circumstance which justify treatment of student as self-supporting (attach other sheets as necessary):_____________________________________________________________

5. Attach documentation; describe below.

Nature of documentation:___________________________________________________

Source:__________________________________________ Date received:__________

Nature of documentation:___________________________________________________

Source:__________________________________________ Date received:__________


Student signature:_________________________________________________________

SCHOOL SECTION:6. approved:_____________ denied:_____________ date:___________

Additional information requested:__________________________________Date requested:______

Staff:_________________________________________

Mail or fax this form along with documentation of your circumstances to:


Financial Aid Office
Empire State College
111 West Ave.
Saratoga Springs, NY 12866

FAX: 518-581-2782
Phone: 518-587-2100

Contact us

financialaid@esc.edu

Fax: 518-581-2782

Mailing Address: 
Empire State College
Financial Aid
111 West Ave.
Saratoga Springs, NY 12866

Questions? Contact the Student Information Center at 518-587-2100 or 800-847-3000.

FAFSA Info

Code: 010286
Name: SUC Empire State College

TAP Codes

Undergraduate: 0913
Graduate: 5680 (for graduate students applying for Veteran Tuition Awards)

Announcements

Students planning to attend the spring 2 term starting in March 2017 should complete the 2016-2017 Free Application for Federal Student Aid.   Students who plan to attend starting in May 2017 or thereafter should apply for financial aid for 2017-2018 by submitting the 2017-2018 FAFSA.

Take the Next Step

Ready to advance your education and career? There’s no time like the present. Apply now, or learn more about SUNY Empire at one of our information sessions.