2019-20 Signature Submission
Institutional Student Information Record
Oce of Financial Aid | ENMU Station 20 | 1500 S Ave K | Portales, NM 88130
Student Academic Services (SAS), Room 107 | Phone: 575.562.2194 | Fax: 575.562.2198
PN3132 • 3/19
ENMU ID: SSN: Phone number:
Student name:
Last First Middle initial
Address:
Address City State ZIP
Read, Sign and Date
By signing below, you certify all the information on the FAFSA form is true and complete to the best of your
knowledge. If asked, you agree to give proof of the information, which may include your federal or state
income tax information. If you purposely give false or misleading information, you may be fined $20,000,
sent to prison or both. You also certify that:
• You will use any federal student financial aid funds received during the award year covered by this
application solely for educational expenses related to attendance during that year at the institution of higher
education that determined eligibility for those funds.
• You are not in default on a Title IV educational loan, or you have repaid or made satisfactory arrangements to
repay your loan if you are in default.
• You do not owe an overpayment on a Title IV educational grant, or you have made satisfactory arrangement
to repay that overpayment.
• You will notify your school if you do owe an overpayment or are in default.
The student (and at least one parent/stepparent, if dependent student) must sign below.
Student signature Date
Parent/Stepparent signature (required if student is dependent) Date
Financial Aid
