Return to: Financial Aid Office
5500 Irvine Center Drive
Irvine, CA 92618
Tel: (949) 451‐5287
Fax: (949) 451‐5459
2016‐2017 Proof of Independent Status Last Name: Student ID Number: First Name: You have indicated on your FAFSA that one of the following circumstances applies to you. Please check the category that applies to you and attach the documentation required. As of the day I completed my FAFSA, I am married. Check if you are separated but not divorced. Attach a copy of your marriage certificate for proof of your marital status. I am pregnant or have children who receive more than half of their support from me. If pregnant, attach a copy of the doctor’s letter showing anticipated due date. If you have children, attach a copy of their official birth certificate showing you as a parent. You must provide more than half of a child’s support to claim the child as a dependent. I have dependents (other than my children and spouse) who live with me and who receive more than half of their support from me, now and through June 30, 2016. Attach a copy of your 2015 Federal Tax transcript or provide legal documents that list your dependents. The individual that you claim to be supporting must be listed on your 2015 federal tax transcript as an exemption or on the legal documents. I am an orphan, or I was (until age 18) a ward/dependent of the court, or I was in foster care at any time since the age of 13. If you are an orphan, attach a copy of the death certificate for both legal parents. If you are a ward of the court, attach a copy of the court documents. If you were in foster care at any time since the age of 13, attach a copy of legal documentation from the proper legal authority. I am a veteran of the U.S. Armed Forces. Attach a copy of your DD214 “Member 4 Copy” with the discharge status at the bottom of the document. I am or I was an emancipated minor as determined by the court in my state of legal residence. Attach a copy of legal documentation from the court of your state of legal residence. The court must be located in your state of legal residence at the time the court’s decision was issued. I am or was in legal guardianship as determined by the court in my state of legal residence. Attach a copy of legal documentation from the court of your state of legal residence. The court must be located in your state of legal residence at the time the court’s decision was issued. As of July 1, 2015, I was determined to be an unaccompanied youth who was homeless. Please complete the back side of this form and return to the Financial Aid Office. If none of these categories apply to you, you are dependent and must provide parental information and a parent signature on your Student Aid Report, and submit it to the Department of Education for processing. If you feel that you are Independent, you may contact the Financial Aid Office for further information. Date:
Signature: Page 1 of 2 Return to: Financial Aid Office
5500 Irvine Center Drive
Irvine, CA 92618
Tel: (949) 451‐5287
Fax: (949) 451‐5459
2016‐2017 Proof of Independent Status Last Name: First Name: Student ID Number: Verification of Unaccompanied Homeless Youth A signature from one of the following official individuals is required to complete this verification. Please submit to the appropriate individual and return to our office after completion. I confirm that I am one of the following (check one): A High School or School District Homeless Liaison: Name: Signature:
Phone: Email:
A Director or Designee of HUD‐funded shelter: Name: Signature:
Phone: Email:
A Director or Designee of a Runaway or Homeless Youth Basic Center or Transitional Living Program: Name: Signature:
Phone: Email:
And that the aforementioned student was (check one): An unaccompanied youth who was homeless on or after July 1, 2015. An unaccompanied youth who was self‐supporting and at‐risk of being homeless on or after July 1, 2015. Page 2 of 2