Low Income

INCOME

Student Name Social Security #

Banner ID Number C

The income reported on your application for federal student financial aid was very low. Normally a student and his/her family must pay expenses for basic living costs of room and board. If there was little or no income, please explain below how these expenses were paid. (Attach additional pages, if needed.) If you were required to report parents’ income on the FAFSA, please provide an explanation of how parent expenses were met. If you were not required to report parents’ income, please explain how student expenses were met.

_____________________________________________________________________________________

If these expenses during 2011 were paid by someone whose income is not required to be reported on the financial aid application, please explain the relationship and have that person sign the statement below.

I provided room and board for the above named student during 2011. I also provided cash assistance of

$______________ during 2011.

Signature ________________________________________________ Date__________________

Signature of Student________________________________________ Date__________________

Signature of Parent ________________________________________ Date__________________

(if dependent)

Return to: Financial Aid Office at Cayuga Community College

Processing of your application for Financial Aid cannot continue until we receive the requested information.