2018-2019
Citizen and Eligible Non---Citizen Verification
Student ID
Last Name ______________________________ First Name_______________________________
To receive financial aid, Federal law requires the student to be either a US Citizen or National or an Eligible Non-Citizen. Please review the
acceptable documentation below and submit 1 photocopy, front and back, of the indicated documentation. Documentation of non---US
citizens must not have an expiration date prior to the start of the academic year and will be submitted by PCC to the Department of Homeland
Security for confirmation.
Eligible Categories Required Documentation
US Citizen or National US Birth Certificate, US Passport/Passport Card current or expired, Certificate of Naturalization (form N
---
550
or N
---
570),
Certificate of Citizenship (form N
---
560
or N
---
561),
or Documentation of Citizen Abroad (form FS
---
240, FS
---
545, or DS
---
1350.
US Permanent Resident
Permanent Resident Card (form I
---
551,
Resident Alien Card (form I
---
551),
Departure Record (form I
---
94),
Arrival Departure Record (form I
---
94) with the endorsement ‘Processed for I
---
551’. ‘Temporary I
---
551’ or
‘Processed for I
---
551’.
Temporary Evidence for Lawful Residence, or Visa in an unexpired foreign passport
with a US Customs and Border Protection inspector admission stamp and the statement ‘Upon
Endorsement Serves as Temporary If I-551 Evidencing Permanent Residence for 1 Year’, or US Travel
Document
(form
I-327 with stamp ‘Permit to Reenter’).
Refugee
Departure Record (form I
---
94A) or Arrival Departure Record (form I
---
94) with stamp showing admission as
refugee under Section 207 of the Immigrati
on and Nationality act or ‘209b Pending. Employment
Authorized’, or US Travel Document (form I
---
571) with stamp ‘Permit to Reenter’.
Asylee
Departure Record (form I-94A
) or Arrival Departure Record (form I-94) with stamp showing admission
asylee under Section 208 of the Immigration and Nationality Act or ‘209b pending. Employment Authorized
or US Travel Document (form I-571)
with stamp ‘Permit to Reenter’.
Parolee
Departure Record (form If
94A) or Arrival Departure Record (form I-94) with stamp indicating 'Alien
paroled into the US pursuant to Section 21
2 (d)(5)'.
Victim of Human
Trafficking or Spouse, Child
or Parent of Victim
Victim must submit certification letter from the Department of Health and Human Services. Spouse,
child or par
ent of victim must submit a copy of the victim’s certification letter and a copy of their
T-Visa.
Ineligible Categories
•
Applicant for Permanent Resident Status and not in a category listed above
•
A Student with a non
---
immigration Visa
•
A Student with only an Employment Authorization
Certification: I hereby certify that all information reported on this form and any attachments hereto are true, complete, and
accurate. Further, I understand that false statements and/or misrepresentations will result in denial, reduction, withdrawal,
and/or repayment of aid disbursed and student disciplinary action may be taken.
Student
Si
gnature____________________________________________________ Date______________
1570 East Colorado Blvd. L-114, Pasadena, California 91106
---
2003
19CITZ
