Parent Fafsa Refusal Form 2016-2017 printable pdf download

Parent Fafsa Refusal Form 2016-2017

Parent FAFSA Refusal Form 2016-2017

Attention Parent: Complete this form only if you (the parent) are unwilling to provide information

in Section 3 of the Free Application for Federal Student Aid (FAFSA) for the student

listed below. By refusing to complete the parental section of the FAFSA, the student’s

FAFSA application cannot be considered complete and he/she cannot be considered

for federal student aid, except a Federal Unsubsidized Stafford Loan.

Print Student Name:

Student ID Number:

PARENT CERTIFICATION

I certify that the following statements are true:

I am the parent of the above named student.

I stopped providing financial support

to the above named student as of (date support ended):

I will not provide financial support

to the above named student in the future.

I refuse to complete the parental section of the above named student’s FAFSA.

* Financial support includes not only payment by the parent of educational costs, but also providing

other cash and non-cash support to the student such as room and/or board, health insurance, etc.

Parent Name (Last/First):

Parent Signature:

Today’s Date:

You must print and mail OR return this form to: GRCC Financial Aid Office

143 Bostwick Avenue, NE

Grand Rapids, MI 49503-3295

OR FAX this form to:

(616) 234-4091

OR scan/e-mail this form to:

financialaid@grcc.edu

•

143 Bostwick Avenue, NE

Grand Rapids, Michigan 49503-3295

ph: (616) 234-GRCC

Grand Rapids Community College is an equal opportunity institution. GRCC is a tobacco free campus.

This publication is available in alternative formats upon request. Please contact the Financial Aid department for more details. 54773 10/15

Parent Fafsa Refusal Form 2016-2017