Return form to:
Financial Aid Office
Ben Parker Student Center, Golden CO 80401
303-384-2252 fax
Independent Student Documentation Form 2017-2018
Student: _______________________________________ Campus Wide I.D.#:________________________
On your 2017-2018 Free Application for Federal Student Aid (FAFSA) you indicated that you are an independent student based on one
or more of the criteria below. You must verify your self-supporting status by providing documentation for ONE of the fol owing.
Please document your marital status by providing a copy of your marriage certificate.
Is your spouse also a Mines student? No______ Yes________ Spouse CWID___________________
I am stil married to the same person as documented in a previous year.
Graduate Student:
I have completed my Bachelor’s degree and am admitted to pursue a Master’s or Doctoral degree at Mines this academic year.
Armed Forces:
I am a veteran of the U.S. Armed Forces. Please provide a copy of your DD214 indicating a separation other than a
“Dishonorable Discharge.”
I am currently serving in the U.S. Armed Forces or are a National Guard or Reserve enlistee who is on active duty for other than
state or training purposes. Please provide your orders which state the reason and dates of your active duty status.
I am stil serving in the U.S. Armed Forces as documented in a previous year.
Orphan, Foster, Ward, Emancipated Minor or Legal Guardianship:
Orphan: At any time, since I turned age 13, I have no living (biological or adoptive) parents. Submit documentation.
At any time, since I turned age 13, I was in foster care, a dependent or ward of the court, or an emancipated minor. Submit
court documentation verifying your status. Only documentation from a court of law is admissible.
Legal Guardianship: I am or was in legal guardianship immediately before adulthood as determined by a court in my state of
legal residence. Submit court documentation. Legal Guardianship only applies if your guardian is not a parent.
Legal Dependent(s):
I have children who receive more than half their support from me. Please submit a copy of your 2015 federal tax return
showing dependents claimed as exemptions. If children were not claimed, provide court documents showing your obligation
and payment of child support, or cancel ed checks showing support being paid. A copy of a Medicaid card is not sufficient.
I have dependents (other than your children or spouse) who live with me and who receive more than half their support from
me now and through June 30, 2018. Please provide proof of support.
I am stil supporting the children/dependents documented in a previous year.
Unaccompanied Youth or At Risk of Homelessness:
I am an unaccompanied youth who is homeless or at risk of being homeless according to my high school, school district
homeless liaison, director of an emergency shelter, or transitional housing program funded by HUD. Submit an official letter of
Unaccompanied Homeless Youth designation from the proper authority.
I am stil in the same housing situation as documented in a previous year.
Answered FAFSA incorrectly:
I answered incorrectly and none of these conditions apply to me. By checking this box, I understand that I wil need to return
this form to the Office of Financial Aid and correct my FAFSA by changing this answer to “no”. I wil also need to add
parental information as well as a parent signature.
Additional documentation may be requested as part of the verification process.
Student Signature