2019-2020 (Out of State) Identity and Statement of Educational Purpose 19IDENT(OFS)
(Out of State) Identity and Statement of Educational Purpose
(
To Be Signed in the Presence of a Notary)
Your FAFSA application indicates to us, that you must provide an Identity and Statement of Educational Purpose. In order to
process your 2019-2020 Financial Aid Application, our office needs this document before we are able to determine your
eligibility for financial assistance.
If the student is unable to appear in person at MT. SAN JACINTO 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
below, 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 provided below, 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.
Statement of Educational Purpose
I certify that I _______________________________ am the individual signing this
(Print Student’s Name)
Statement of 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 Mt. San Jacinto College for 2019-2020.
____________________________ _______________ ___________________
Student’s Signature Date Student’s ID Number
Notary’s Certification of Acknowledgement
State of
City/County of
on _ , before me,
__ ____
, personally appeared,
(Date) (Notary’s name)
________________________________________, and proved 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 unexpired government-issued photo ID provided)
WITNESS my hand and official seal
(Seal) __________________________________________
(Notary Signature)
My commission expires on __________________________
(Date)
2019-2020 OUT OF STATE
IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE
STUDENT INFORMATION
Please PRINT clearly with black/blue ink
SJC Financial Aid Office * 1499 N State Street * San Jacinto, CA 92583 * Telephone: (951) 487-3245
MVC Financial Aid Office * 28237 La Piedra Road * Menifee, CA 92584 * Telephone: (951) 639-5245
Email: finaid@msjc.edu * Website: www.msjc.edu
