Independent students applying for financial aid are required to supply one of the following documents listed below to UCSD
Financial Aid Office to verify their independent status. Dependent students required to supply parental information on the
2013-14 Free Application for Federal Student Aid (FAFSA)or California Dream Act Application should not submit this form.
To receive priority funding, you must submit this form by the May 21, 2013 deadline.
I certify that all of the information provided on this form is true and correct. Any attached documents required to verify
my independent status are true and exact copies of the originals.
Student's Signature_______________________________________________ Date_________________