HVCC Financial Aid Office Phone 518-629-7150 Guenther Room 110
80 Vandenburgh Ave Monday-Friday
Troy, NY 12180 8AM-5PM
Mastrangelo Financial Aid Center
2018-2019 Certification Page
Your Free Application for Federal Student Aid (FAFSA) has rejected as it was not completed with the
proper signature requirements. Your FAFSA can be signed electronically by creating a Federal Student
Aid (FSA) ID at https://fsaid.ed.gov for yourself and a parent (if required). Note: Parents must have their
own FSA ID. Please add required FSA IDs to your online FAFSA at www.fafsa.gov OR complete this
form and submit to the Financial Aid Office and we will update your application. Please be aware that
additional personal information or financial documents may be requested once your FAFSA is processed
with proper signatures.
Student Name
Date of Birth
Social Security Number
READ, SIGN, AND DATE
If you are the student, by signing this application you certify that you (1) will use federal and/or state
student financial aid only to 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 college if you default on a federal student loan and (5) will not receive a Federal Pell Grant from
more than one college for the same period of time.
If you are the parent or the student, by signing this application you certify that all of the information you
provided 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 sign any document related to the federal
student aid programs electronically using an FSA ID (username and password) and/or 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 $20,000, sent to prison, or both.
The student (and at least one parent, if parent information is required on the FAFSA) MUST sign below.
Student Signature
Date
Parent Signature
Date
Please return this original form to the Financial Aid Office.
We cannot accept a copy or a fax of this document.