Office of Financial Aid
2022 - 2023 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. Name of Valid Photo ID
Name of U.S. Citizenship Document
VALID PHOTO IDENTIFICATION
U.S. CITIZENSHIP DOCUMENTATION
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)
2022 - 2023
Office of Financial Aid
Citizenship Verification Form
Student Name: _________________________________________________
Student ID: _______________________
ELIGIBLE NON-U.S. CITIZEN – COMPLETE THIS PAGE •
Provide a copy of documents proving you are a U.S. citizen or an eligible non-citizen. This may include: Permanent Resident Card, I-551, I-94, T-Visa, or other official documentation
• •
Provide a copy of a photo identification. This should be non-expired and issued by the government. This form must be signed in the presence of a notary public.
List the documents attached in the spaces below. VALID PHOTO IDENTIFICATION
Name of Valid Photo ID
Name of Immigration Document(s)
U.S. IMMIGRATION DOCUMENTATION
Expiration Date 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)
Notary’s Certificate of Acknowledgement State of ______________________________________ City/County of __________________________________________ On_____________________, (Date)
before me,______________________________________________, (Notary’s name)
personally appeared, ___________________________________, and provided to me on basis of satisfactory evidence of identification (Printed name of signer) _______________________________________ to be the above-named person who signed the foregoing instrument. (Type of government-issued photo ID provided) WITNESS my hand and official seal (seal)
________________________________________ (Notary signature) My commission expires on ______________________ (Date)