Financial Aid Office
2020-21 FAFSA Signature(s)
Complete this form, sign, date and drop off at Financial Aid ofﬁce, SSC L177, mail to Manchester Community College, Financial Aid Ofﬁce, Great Path, MS #11, P.O. Box 1046,
Manchester, CT 06045-1046, or fax to 860-512-3381. For more information, contact the Financial Aid ofﬁce at 860-512-3380. You may also scan and email your signed form
to FinAid@mcc.commnet.edu. Electronic signatures and pictures (.jpg) of documents are not accepted.
First Name MI Last Name Banner ID Number
City State Zip
By signing this form and submitting it to the ﬁnanical aid ofﬁce, you certify that you:
1. will use federal and/or state student ﬁnancial aid to only pay the cost of attending an institution of higher education,
2. are not in default on a federal student loan or have made satisfactory arrangements to repay it,
3. do not owe money back on a federal student grant or have made satisfactory arrangements to repay it,
4. will notify your school if you default on a federal student loan, and
5. will not receive a Federal Pell Grant from more than one school for the same period of time.
By signing a signature page and submitting it to our ofﬁce, you agree to provide if asked:
1. information that will verify the accuracy of your completed form, and
2. federal tax transcripts if you ﬁled or are required to ﬁle.
You also certify that you understand that the Secretary of Education has the authority to verify information reported on your application with the Internal Revenue Service
and other federal agencies. If you purposely give false or misleading information, you may be ﬁned $20,000, sent to prison, or both.
If parental information is provided on the FAFSA, at least one parent must sign.
Student Signature Date
Parent Signature Date
If you or your family paid a fee for someone to ﬁll out this form or to advise you on how to ﬁll it out, that person must sign.
Preparer’s Certiﬁcation: All of the information on this form is true and complete to the best of my knowledge.
Preparer’s Signature Date
Date Received _______/_______/__________ Reviewed By ______________________________