Office of Financial Aid
2021 - 2022 Citizenship Verification Form
Student Name: _________________________________________________
Student ID: _______________________
U.S. CITIZEN – COMPLETE THIS PAGE •
Provide a copy of documents proving you are a U.S. citizen. This may include: ➢ U.S. Birth Certificate, U.S. Passport, Certificate of Naturalization
•
Provide a copy of a photo identification. This should be non-expired and issued by the government.
List the documents attached in the spaces below. VALID PHOTO IDENTIFICATION Name of Valid Photo ID
U.S. CITIZENSHIP DOCUMENTATION Name of U.S. Citizenship Document
Certification of True, Exact and Complete Copy of the Original Document I certify that I _____________________________ am the individual signing this statement. (Print Student’s Name) I am providing a copy of my documents along with a copy of a valid government-issued photo identification card bearing my portrait (or likeness). I certify that the attached documents and government issued photo identification are the true, exact, and complete copies of the originals issued to me.
________________________________________________________ (Student’s Signature)
_______________________ (Date)