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Financial Aid & Scholarships


2021-2022 Loss of Income for Parent (Dependent Student)


Financial aid for the 2021-2022 academic year is based on the total 2019 income reported on the Financial Aid Application. If your family's financial situation has changed and conditions qualify, you may file a Loss of Income Appeal.

2021-2022 Deadlines

Attending Fall Only: November 12, 2021
Attending Academic Year/Spring 2022: March 4, 2022


Step 1 - Parent Information

Enter the name of parent(s) listed on the Financial Aid Application (if married, list both parents) AND select which parent has a loss of income.

Parent 1 -

Parent 2 -

Step 2 - Student Enrollment

Identify your Sac State student:
Student's First Name:   Student's Last Name:   Sac State Stuent ID:

From the menu below, select what semester(s) your student will be attending Sac State.
Step 3 - Loss of Income Tax Year and Documentation

For the parent(s) who in Step 1, selected they have a loss of income, in which tax year did the loss occur?
Meaning, which tax year (either 2020 or 2021), are you projecting that your total income (between you and your spouse, if married) will be less than the 2019 income reported on the Financial Aid Application? (Select one)

2020

2021


Submit the following documentation for you and your spouse (if married):
    -- All 2020 W2s and other tax documents (i.e., 1099-R, etc.)
    -- Signed 2020 Federal Tax Return and all schedules (if applicable)
    -- If divorced or separated in 2020: Submit a copy of dissolution of marriage or separation AND all 2020 W2s and other tax documents for you and your spouse, including your signed 2020 Federal Tax Return and schedules (if applicable)
    -- Federal benefit document verifying benefits (i.e., TANF, SNAP, Medicaid/SSI, Free School Lunch, WIC) received
    -- All 2020 income documents/letters (i.e., EDD claim letter, Social Security benefits, retirement benefits, etc.)

Submit the following documentation for ALL employers worked for in 2021, for you and your spouse (if married)

    -- Paystubs for the lasts 3 months from all employers
    * Reduction of work hours: Provide a letter from employer on company letter head, indicating new hours, when change became effective and if applicable, change to hourly rate
    -- For separation (loss of employment): Provide a letter from the employer, on company letterhead, with last day worked. Submit with last paystub received that includes earnings through last day worked
    -- If divorced or separated in 2021: Submit a copy of dissolution of marriage or separation AND all 2021 W2s and other tax documents for you and your spouse, including your signed 2021 Federal Tax Return and schedules (if applicable)
    -- Federal benefit document verifying benefits (i.e., TANF, SNAP, Medicaid/SSI, Free School Lunch, WIC) received
    -- All 2021 income documents/letters (i.e., EDD claim letter, Social Security benefits, retirement benefits, etc.)

If submitting Loss of Income Appeal or documentation after December 1, 2021, a signed 2021 Federal Tax Return will be required (if applicable), 2021 W2s and/or other 2021 income documents to verify total income earned/received in 2021.


Certification Statement

By entering your name and email address below, you certify that all the information on this form and submitted documentation are complete and accurate. You must promptly report any corrections, changes, or updates to the Financial Aid & Scholarships Office if/when they occur after this form is submitted.

First Name:   Middle:   Last Name:
Parent Email Address: