Fillable Parent Fafsa Refusal Form printable pdf download

Parent FAFSA Refusal Form

Financial Aid Services

2017-2018

Student Name: _______________________________________________________ SPIRE ID#:__________________________

Last, First MI

Federal regulations give schools the authority to allow a student to borrow a Federal Direct Unsubsidized Loan when the student’s

parent(s) have ended all fi nancial support and have refused to complete and sign a Free Application for Federal Student Aid (FAFSA).

Students who request consideration for the loan should read the information on our website about unsubsidized loans and have one

parent complete and sign this form.

Note:

 This form does not allow you to apply for fi nancial aid as an independent student.

 You are requesting only an unsubsidized loan subject to the limits for dependent students.

 No other federal, state or university need-based aid will be available, including the Federal Direct Parent PLUS Loan.

INFORMATION FOR STUDENT:

If you meet the conditions above but your parent will not sign this form, you may submit a letter from a third party (e.g., teacher,

counselor, clergy, or court) who is familiar with your situation and can describe your relationship with your parents. The letter must

be on appropriate letterhead.

THIS SECTION IS TO BE COMPLETED BY THE PARENT:

Parent Name: _______________________________________________ Telephone #: (

) _____- _______

Parent Address: ______________________________________________________________________________

City:_________________________________ State:________ Zip:__________

By my signature below I attest to the following:

That as of the following date _____/_____/_______

yyyy

 I have stopped providing fi nancial support to the student named above (including payment of educational costs

as well as all other cash and noncash support to the student such as room and/or board; and/or medical insurance).

 I will not provide fi nancial support to the student in the future, and

 I refuse to complete the parent section of the Free Application for Federal Student Aid (FAFSA).

Parent signature__________________________________________________ Date ____________________

Fax completed, signed form to: 413-545-1700

or email completed, signed form to: fadocs@fi naid.umass.edu

(Attachments must be a standard image fi le, or in one of the following fi le formats: .doc, .docx, .pdf )

*FDOUNS*

Parent Fafsa Refusal Form