Federal Dependency Override Request

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Student Financial Services

3690 East Avenue

Rochester, NY 14618

Phone: 585-385-8042

E-mail: sfs@sjf.edu

FEDERAL
DEPENDENCY OVERRIDE REQUEST

Independence may be granted where there is an involuntary separation from the family or if other extraordinary circumstances exist. An involuntary dissolution occurs when a student is separated from the family for reasons other than his/her or their parents' own choice. Documentation is required and must be attached to this request.

Please attach at least one letter of third party documentation from a professional (counselor, attorney, teacher, etc.) that knows you and your situation and can explain it in detail. *This documentation must be on official letterhead and state the reason for the involuntary dissolution of the family. It must also contain a certification that in the third party's opinion, it was in the student's best interest (physical, mental or other) to leave the home environment.

Please note: If a letter from a professional is not possible, please explain why and obtain three letters from persons that know your family situation first-hand. Please have them state their relationship to you in their letter. Additional documentation may be required.

*If you have been approved for a dependency override by St. John Fisher University in the past, please confirm your current status in the spaces below. If your circumstances have changed, we will require further documentation from a professional.

First Name:

Last Name:

ID Number:

Telephone Number:

Email Address:

Date left parent(s) or guardian(s) home (if applicable):

Please explain your current relationship with both your biological father and mother even if they are currently divorced or separated:

Reason for leaving:

Third Party Documentation:

Student Signature (First & Last Name):

Date:

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