Provide supporting documents with Reconsideration Request Form
Reason for Reconsideration
Required Supporting Documentation
1. Disagree with:
Copy of documentation to dispute application status or decision made.
Incomplete/Late:
Application status
•
USPS Service Receipt.
•
Late, Incomplete or Ineligible
Turndown:
•
Verification of Hawai‘i Residency:
Decision made
•
Options:
Turndown
•
Tax Filers:
No Funds
o
Submit signed copy of filed personal 2015 state tax return.
Non-Tax Filers:
o
Hawai‘i voter verification.
Residential military release or discharge.
Tuition statement from last post-secondary institution attended.
•
Max funding for KS award
Request an extension to be ELIGIBLE for an award. Must be based
o
on extenuating circumstances and supported by documentation.
No Funds:
•
Case by case requirements may be requested.
2. Change of academic status
Copy of official transcripts, letter from school representative to confirm program,
enrollment or conferred/anticipated degree.
3. Change place of residence
Copy of current rental agreement or housing contract.
(PreK-12 Programs only)
4. Change in size of family
Copy of birth announcement from medical facility or court documents of adoption
for added family member.
•
5. Change in employment status
Copy of last pay stub from former employer in current calendar year for
•
student, spouse, or parent(s); if applicable.
Termination, unemployment,
•
change of employment, change
Copy of recent pay stub from current employer for student, spouse, or
of employment from full time
parent(s); if applicable.
to part time, position change,
•
Letter from employer on company stationery regarding employment
decrease in salary/wages,
status change; reduced hours, termination, etc.
retirement.
•
Copy of documentation verifying income not from employment. (i.e.
unemployment benefits, worker’s compensation, untaxed pension
amounts, veteran’s benefits, etc.)
•
Documentation of anticipated retirement benefits (including social
security) received by all members of family in the current year.
•
6. Change in marital status
Copy of marriage certificate, separation agreement or divorce decree.
•
If no separation agreement or divorce decree, provide a statement
indicating date of intended separation/divorce.
Separation must be with the intent to divorce; couple must reside at
o
different addresses.
•
Is there an agreement of financial support payments? (e.g. child support)
If yes, please list amount of child support payment and provide
o
proof of child support payments.
•
Updated list of dependents in current household.
7. Loss of assets
Copy of documentation evidencing loss of assets. (e.g. letter from the lender or
financial institution, financial statements after date of loss, etc.)
Document No. 065AI
Rev. 12/17/2015
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