FINANCIAL RESOURCES LESS THAN $4,000.00

OR OTHER UNUSUAL CIRCUMSTANCES

Please complete if your Student Aid Report (SAR) indicates income or financial resources of less than $4,000.00 for the __________ calendar year.  Or if you have other unusual circumstances, you must explain how you survived in the _________ calendar year on the resources reported on your SAR. 

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Do you live with a friend or relative? _______            Name_________________________

Do you receive food stamps?_________                Subsidized Utilities?_____________

Do you receive subsidized housing?_______                    Monthly Rent Allowance _________

Do you receive support not reported on the SAR such as food, clothing, or shelter from friends, relatives, a church, etc.? ____________________________________________

Note:  Any cash provided to you or cash paid on your behalf must be reported on the SAR as untaxed income.

Signature                                                          Date

Forms Page

  Updated 8 July, 2003