2017-2018
STUDENT CONTRIBUTION REVIEW FORM
Change in Marital Status


_________________________________ __________________ ___________________@mymail.mines.edu
STUDENT NAME (PRINT CLEARLY) CWID NUMBER
EMAIL ADDRESS





SPOUSE NAME (IF APPLICABLE)
PHONE


Divorce/legal separation after you applied for federal financial aid (which included spouse information)

• Copy of divorce decree or legal separation documentation
• If you filed a joint tax return, submit a copy of the 2015 and 2016 Tax Return Transcripts and the W-2s for you and/or
your ex-spouse.
• If you filed a separate tax return, submit a copy of you and your ex-spouse’s 2015 Tax Return Transcripts and your
2016 Tax Return Transcript.
• If you did not file taxes, please fill out the Non-filer Form, tax filing letter from the IRS and include your 2015 and 2016
W-2s.
• Household Member Form completed as of today


Death of a spouse after you applied for federal financial aid (which included spouse information)

• Copy of spouse death certificate
• If you filed a joint tax return, submit a copy of the 2015 and 2016 Tax Return Transcripts and the W-2s for you and/or
your spouse.
• If you filed a separate tax return, submit a copy of your 2015 and 2016 Tax Return Transcripts.
• If you did not file taxes, please fill out the Non-filer Form, tax filing letter from the IRS, and include your 2015 and 2016
W-2s.
• Household Member Form completed as of today


The Financial Aid Office must verify the original 2015 tax information before updating your FAFSA to your 2016
information. All documentation must be provided before your review request will be processed. If you have other
extenuating circumstances we should consider, please contact our office for additional information.

I certify that the information provided is true and that false or misleading information will be cause for repayment of
financial aid funds received. Due to limited funding, approval of a Contribution Review does not guarantee that additional
funds will be awarded.







STUDENT SIGNATURE
DATE




Return this form and required documentation to the Mines Financial Aid Office
finaid@mines.edu
Ben Parker Student Center, Golden, CO 80401
Phone: (303) 273-3301 or 888-446-9489 • Fax (303) 384-2252