Special Circumstance Termination: Terminated/Dislocated Worker: Provide an official letter from employer stating the effective date of termination. In addition, please provide documentation of earnings to date with this application (final pay stub, employer’s statement, severance pay documentation.)Disability:Attach medical documentation of disability determination and the effective date. In addition, you must provide documentation of earnings to date with this application (final pay stub, employer’s statement, etc.). If you are currently receiving disability benefits, please submit Disability Award Letter. Layoff: Provide an official letter from employer stating the effective date. In addition, you must provide official documentation of earnings to date with this application (final pay stub, employer’s statement, severance pay documentation, etc.) Reduced Employment: Provide an official letter from employer stating the effective reduction of employment date. Also state the current adjusted employment. In addition, please provide documentation of earnings to date with this application (final pay stub, employer’s statement, etc.) Death of a Spouse/Parent: Complete the Income Worksheet of this form. Since applying for financial aid, your spouse (I) or a parent (D) is no longer living. Provide documentation of the date of death (death certificate), copy of 2019 W-2 (s) and a signed copy of 2019 federal tax return.Divorce/Separation: Since applying for financial aid, you and your spouse (I) or your parent’s (D) have become divorced or separated. Provide legal documentation containing the date of the divorce or legal separation, copy of 2019 W-2(s) and signed copy of 2019 federal tax return. One Time Income: Complete the Income Worksheet of this form. In 2019, you and your spouse (I) or your parents (D) received a one-time source of income such as inheritance, moving expense allowance, back-year social security payments, severance pay package, Ira distribution, etc. Provide a signed copy of 2019 tax return indicating moving expenses, IRA distribution, etc., or documentation from the Social Security Administration for back-year payments. Note: Winnings from gambling are not considered a special circumstance.List the one-time source of income Elementary/Secondary Education and Adult Care Expenses: Provide documents for each family member you included in your family size on your application for financial aid for whom you (I) or your parents (D) paid tuition/fees for private elementary/secondary education, or adult care expenses. Documentation required signed 2019 tax return transcript (to verify dependents) and receipts for tuition or adult care payments made in 2019. Family Member Name Relationship to Student Include Parents in the Number of College (Dependent Student Only): Your parents can not automatically be included in the number in college. If your parents are pursuing an undergraduate or graduate degree, an adjustment to your financial aid application can be made. Provide a signed copy of parent’s degree plan from the school or university they are attending or a copy of their academic transcript. Unusually High Medical/Dental Expenses: Note: Medical/dental expenses up to 11% of the family’s total income are already taken into account by the Federal Needs Analysis Formula when determining financial aid eligibility. Therefore, only the portion of expenses which exceed 11% will be considered and unusual circumstance. If you and your spouse (I) or your parents (D) itemize medical/dental expenses in 2019, provide a signed copy of the 2019 tax return, including Schedule A. If medical/dental expenses were not itemized in 2019, provide receipts of medical/dental expenses paid in 2019 and prepare a Schedule A using that information. List below family member for whom medical/dental expenses were incurred in 2019: Family Member Name Relationship to StudentRoth IRA: A regular IRA has been converted to a Roth IRA by transferring funds. Family Member Name Relationship to Student