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Student Financial Aid and Scholarships

Phone: (775) 784-4666

Fax: (775) 784-1025

Address: Mailstop 076 Reno, NV 89557

Students appealing for independent status must clearly demonstrate how their circumstances would allow for an
override of the federal definition of a dependent student. Approvals are granted for those students who are unable
to get parental information on the FAFSA because of:
1) incarceration of parents;
2) inability to contact parents through normal means (email, mail, phone);
3) abuse in the household that makes contact with parents unsafe; or
4) other extenuating circumstances that limit parents ability to provide information.
A parents refusal to provide data or financial assistance does not justify a request for Independent Status.
Student Name:

Student ID: _____________________

REQUIRED DOCUMENTATION: The required documents or explanations MUST be attached to this appeal.
Provide your name and student NSHE number on every document submitted. Incomplete appeals will not be

STUDENT STATEMENT: Submit a signed statement that clearly outlines 1) the extenuating circumstances
you believe make you independent and 2) specifically describe how you supported yourself during the last
calendar year. If a previous appeal has been approved, an updated student statement is required.
THIRD-PARTY STATEMENTS: Submit a minimum of two detailed third-party statements from other
individuals supporting the fact that you have unique and unusual circumstances. These statements may be from
school counselors, administrators, clergy, physicians, social workers or other individuals who are familiar with
your circumstances. The statements must be submitted on business letterhead and include phone number and
address. If a previous appeal has been approved, third-party statements are not required.
FINANCIAL VERIFICATION DOCUMENTS: Submit 1) the 2014-2015 Independent Verification
Worksheet, 2) copies of both your 2012 and 2013 signed federal income tax returns, 3) copies of all 2012 and
2013 W-2s, and 4) the 2014-2015 Income and Expense Worksheet.
What are your current living arrangements?
relatives (identify who):

Campus Housing
Other (identify):


Were you claimed by anyone on their 2012 or 2013 federal income tax returns?
If Yes, identify person, relationship and year:

With friends or


What is your parents current address and phone number? _____________________________________

CERTIFICATION: I hereby certify that all information reported on this form and any attachments hereto are
true, complete and accurate. False statements or misrepresentations will be cause for denial, reduction,
withdrawal and/or repayment of financial aid.
Applicants Signature: _______________________________________________ Date:________________