2013-2014 Child Support Paid

Federal Student Aid Programs

Cayuga Community College

Financial Aid Office * 197 Franklin Street, Auburn, NY 13021 * FAX 315-252-2185

Auburn Office – 315-255-1743 ext. 2470 * Fulton Office 315-592-4143 ext. 3004

You indicated on your FAFSA that you, your spouse, or your parents are paying child support in 2012. In order to continue processing of your Financial Aid application, you must provide the following information. Please complete the following form. If you are filling out the form online, you will need to enter the necessary information, print the form and provide all required signatures before returning it to the CCC Financial Aid Office. Additional information may be requested.

Name of the person who paid the child support:

__________________________________________________________________________________________

Name of child/children for which support is being paid:

__________________________________________________________________________________________

Amount of annual payments for all children:

__________________________________________________________________________________________

Name of person to whom payments are being paid:

__________________________________________________________________________________________

I certify that the above information is true and complete. I understand that failure to accurately report income may jeopardize my eligibility for Financial Aid. I also understand that the U.S. Secretary of Education has the authority to verify information reported on the FAFSA with the Internal Revenue Service and other federal agencies. I understand that giving false or misleading information may lead to fines up to $20,000, prison, or both.

Student Name______________________________________________________________________________

MyCayuga ID#_______________________________________________________

Student Signature_____________________________________________________ Date______________

Dependent Students

Parent Signature______________________________________________________ Date______________

Return this form to the Financial Aid Office at Cayuga Community College