Fillable 1920V4 Custom Verification (Solano Community College)

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1920V4 Custom Verification (Solano Community College)

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V4_20
Rev. 3/14/19
Office of Financial Aid
2019-2020
CUSTOM VERIFICATION
FORM
Your 2019-2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called
Verification. Federal law says that before awarding Federal Student Aid, we must confirm the information you
reported on your FAFSA. To verify that you provided the correct information, we will compare your FAFSA with the
information on this worksheet and with any other required documents. If there are any differences, your FAFSA
information will need to be corrected.
Complete this verification form and submit it to the SCC Financial Aid Office as soon as possible.
Your financial aid application cannot be processed without this information.
A.
Student Information (Please complete with blue/black ink only)
Last Name First Name M.I
SCC ID Number
Street Address (include apt. number) E-mail address
City State Zip Code
Phone Number
B1. Statement of Educational Purpose and Identity Verification
Instructions: Check one of the boxes below. If unable to appear in person at the Solano Community College, please
check the second box and read additional instructions below.
I am appearing in person with my valid government-issued photo ID (drivers license, state identification card, or
passport). Sign Statement of Educational Purpose on the page 2 then continue to section C.
I am unable to appear in person and have attached a notarized copy of this form AND a copy of my valid
government-issued photo ID (driver’s license, state identification card, or passport). Sign Statement of
Educational Purpose and carefully read instructions below.
NOTE: If the student is unable to appear in person at Solano Community College to verify his or her identity, the
student must provide to the institution:
(a)
A copy of the unexpired valid government-issued photo identification (ID) that is acknowledged in the notary
statement on page 2, or that is presented to a notary, such as, but not limited to, a driver’s license, other state-issued
ID, or passport; AND
(b)
The original Statement of Educational Purpose on page 2, which must be notarized. If the notary statement appears on
a separate page than the Statement of Educational Purpose, there must be a clear indication that the Statement of
Educational Purpose was the document notarized.
Office use only: Made ID copy Date stamped Staff initials:
V4_20
Rev. 3/14/19
Notary Seal
Student’s Name: ___________________________________________________ SCCID#: _____________________________
Identity and Statement of Educational Purpose
(To be signed at the institution OR in the presence of a Notary)
The student must appear in person at Solano Community College to verify his or her identity by presenting an unexpired valid
government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport.
The institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received
and reviewed, and the name of the official at the institution authorized to receive and review the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the Statement of Educational Purpose provided
below.
Statement of Educational Purpose
I certify that I am the individual signing this Statement of
(Print Student’s Name)
Educational Purpose and that the Federal student financial assistance I may receive will only be used for
educational purposes and to pay the cost of attending Solano Community College for 2019-2020.
Student’s Signature Date
SCC ID Number
B2. Notary’s Certificate of Acknowledgement (complete only if unable to appear in person)
State of City/County of
State City or County
On , before me,
Date Notary’s name
personally appeared, , and proved to me on basis of
Printed name of signer
of satisfactory evidence of identification
Type of government-issued photo ID provided
to be the above-named person who signed the foregoing instrument. WITNESS my hand and
official seal
Notary Signature
My commission expires on
Date
PLEASE NOTE: Notary section is for students
who cannot appear in person. Faxed copies will
not be accepted.
V4_20
Rev. 3/14/19
Student’s Name: ___________________________________________________ SCCID#: _____________________________
C. Student’s High School Completion Status
Provide one of the following documents as proof of your high school completion status for
when you begin college in 2019-2020: Must provide original documents
I have a high school diploma
A copy of my high school diploma is attached
A copy of my final, official high school transcript is attached (must include date of graduation)
I have a GED
A copy of my GED Certificate is attached
A copy of my GED Transcript is attached
I received a State Certificate
A copy of my state-recognized high school equivalent certificate is attached
I was home schooled
A copy of California home school academic transcript is attached (must be signed by the parent
or guardian of the home school)
A copy of my home school credential is attached (if homeschooled outside the state of California)
I have a foreign high school diploma
A copy of my “secondary school leaving certificate” or similar government document is attached
None of the above
An academic transcript showing successful completion of a two-year college program is attached
(must be acceptable for full credit toward a bachelor’s degree)
A copy on my Ability-to-Benefit (ATB) test with a passing score is attached (must be dated prior
to July 1, 2012)
An official college transcript with at least 6 completed credit hours toward a degree or certificate
is attached (must have been earned prior to July 1, 2012)
C. Certification and Signature(s)
Each person signing this worksheet certifies that all of the information reported on it is complete and correct.
For Dependent students: the student and one parent must sign and date.
WARNING: Purposely giving false or misleading information on this worksheet may result in fines and/or jail time.
Student Signature Date
Parent Signature (dependent students only) Date
Originals must be submit, faxed copies will NOT be accepted.
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1920V4 Custom Verification (Solano Community College)

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Completed 25 July 2020

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