Mail: Financial Aid Office
Eastern Wyoming College
3200 West C Street
Torrington, WY 82240
2021-2022
Parent Signature and
Certification Form
Your parent did not sign your 2021-2022 Free Application for Federal Student Aid (FAFSA). You may go back online to
StudentAid.gov and have your parent use (or create) his/her Federal Student ID (FSA ID) and password to sign your application
electronically OR you may have your parent complete this form and submit the original, signed in ink, to the Financial Aid Office at
EWC.
___________________________________________________________ ____________________ __________________________
Last Name First Name M.I. EWC Student ID Number Social Security Number (last four digits)
___________________________________________________________ _______________________________________________
Mailing Address (include apartment number) E-mail Address
___________________________________________________________ _______________________________________________
City, ST, Zip Phone Number (include area code)
2021-2022 Institutional Student Information Record
READ, SIGN AND DATE
By signing this Certification Form you, the PARENT, certify that all of the information you provided on
your child’s 2021-2022 Free Application for Federal Student Aid (FAFSA) as seen on the attached
Institutional Student Information Record (ISIR) or Student Aid Report (SAR) sent to you by the
Department of Education is true and complete to the best of your knowledge and you agree, if asked, to
provide information that will verify the accuracy of your completed form. This information may include
U.S. or state income tax forms that you filed or are required to file. Also, you certify that you understand
that the Secretary of Education has the authority to verify information reported on this application with
the Internal Revenue Service and other federal agencies. If you electronically sign any document related
to the federal student aid programs using an FSA ID (username and password) and/or any other
credential, you certify that you are the person identified by that username and password and/or other
credential, and have not disclosed that username and password and/or other credential to anyone else. If
you purposely give false or misleading information, you may be fined up to $20,000, sent to prison, or
both.
The parent MUST sign in ink below.
PRINT student name: _______________________________________ Social Security # (last four digits):____________
PRINT parent name: ________________________________________ Social Security # (last four digits):____________
PARENT signature: __________________________________________________ Date: __________________________
THE DEPARTMENT OF EDUCATION REQUIRES ORIGINAL SIGNATURES ON THIS DOCUMENT.
COPIES OR FAXES OF THIS DOCUMENT ARE NOT ACCEPTABLE.
PLEASE MAIL OR HAND DELIVER ORIGINAL FORM TO EWC.
10/2020
PARENT CERTIFICATION AND SIGNATURE
