937.328.6034 | ﬁnancialaid@clarkstate.edu | 570 East Leel Lane, Springﬁeld, Ohio 45505
2020-2021 Proof of Citizenship
Your FAFSA indicated that your citizenship is not conﬁrmed with the Social Security Administration
or Department of Homeland Security. Complete this form and submit with your citizenship
documentation to the Financial Aid Oce. NOTE: If you cannot submit the documentation to the
Financial Aid Oce, see Section D.
SECTION A: Student Information
Name____________________________________________ Student ID Number___________________
Street City State Zip
Home Phone __________________________________ Work Phone _____________________________
SECTION B: Eligibility
A student must be one of the following to be eligible to receive federal student aid:
• A U.S. citizen or national;
• A U.S. permanent resident or other eligible noncitizen;
• A citizen of the Freely Associated State: the Federated States of Micronesia and the Republics
of Palau and the Marshall Islands. These students can only receive aid from some of the Federal
Student Aid programs.
U.S. Citizenship Documentation:
• A copy of your birth certiﬁcate showing
you were born in the U.S., including Puerto
Rico, Guam, the U.S. Virgin Islands, American
Samoa, Swains Island or the Northern
• A U.S. Passport, current or expired,
excluding a limited passport.
• A copy of Form FS-240 (Consular Report of
• A copy of Form FS-545 (Certiﬁcate of birth
issued by a Foreign Service post).
• A copy of DS-1350 (Certiﬁcation of Report
• A Certiﬁcate of Naturalization (N-550 or
N-570) issued by USCIS.
Eligible Noncitizens Documentation, includes,
but not limited to:
• Permanent Resident Card (Form I-551 since
• Resident Alien Card (Form I-551 before 1997).
• Arrival/Departure Record (CBP Form I-94)
with the endorsement “Processed for I-551”.
• Departure Record (Form I-94A) with the
endorsement “Processed for I-551”.
• Refugees may have Form I-94 or I-94A with a
stamp showing admission.
• Individuals granted asylum will have an I-94 or
I-94A with a stamp showing admission.
• Person’s with nonimmigrant visas, including
work visas, student, visitors and foreign
government ocials are not eligible for
FSA with a Form I-94 with the proper
• Family unity status individuals.
• Temporary residents.
• Illegal aliens under the legalization (amnesty)
• Students with “Temporary Protected Status”
stamped on their I-94.