WARNING: If you purposely give false or misleading information, you may be fined, sent to prison or both.
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OFFICE OF STUDENT FINANCIAL AID
ROBESON COMMUNITY COLLEGE
Student Center Building 13
PO Box 1420
Lumberton, NC 28359
T 910.272.3352 Email: finaid@robeson.edu
F 910.272.3314 Website: https://www.robeson.edu/fa/
2020-2021 Citizenship
Status Confirmation
Form
Student’s Name: _____________________________________________ Student ID: ____________________
Address: __________________________________________ City/State/Zip____________________________
Phone #: ______________________________________ Email: ______________________________________
The U.S. Department of Education requires that we verify your citizenship status. Please submit the required original
documentation in person. If you cannot present the documentation in person, you may send it along with the affidavit.
SUBMIT ONE of the following ORIGINAL documents to the Financial Aid
Office:
• U.S. Birth Certificate
• U.S. Passport or Passport card
☐ U.S. Naturalized Citizen
SUBMIT ONE of the following ORIGINAL documents to the Financial Aid
Office:
• U.S. Passport or Passport card
• Certificate of Birth Abroad (FS-240, FS-545 or DS-1350)
• Certificate of Citizenship (N560, N561)
• Certificate of Naturalization (N550, N570)
☐ U.S. Permanent Resident
BRING ONE of the following ORIGINAL documents to the Financial Aid
Office:
• Alien Registration Receipt/Resident Alien/Permanent
Resident/Conditional Permanent Resident card (I-1551, I-94, I-94A)
• Foreign passport with I-551 endorsement
• Arrival/Departure Record I-94 with I-551 endorsements
☐ Other eligible non-citizen
I-94 designated as “Refugee”; “Asylum Granted”;
“Parolee” or “Cuban-Haitian Entrant”; or
“Conditional Entrant”
BRING ONE of the following ORIGINAL documents to the Financial Aid
Office:
• Arrival/Departure Record (I-94, I94A or I571 with proper
endorsements)
After we receive your documents we will send them to the Department of
Homeland Security (DHS) for verification of your status. If can take up to 8
weeks for DHS to respond.
☐ Victim of Human Trafficking
-OR-
☐ Battered Immigrant-Qualified Alien
SUBMIT ONE of the following ORIGINAL documents to the Financial Aid
Office:
• Eligibility letter from Health and Human Services (HHS) or a T-visa
• Form I-797, Notice of Action form from the US Citizenship &
Immigration Services (USCIS), with a valid expiration date verifying
financial aid eligibility.
Certification: I certify that the information is true and correct to the best of my knowledge and belief. I understand that
RCC has the right to require additional proof of the information provided on this form. I agree to submitting further
documentation if requested.
______________________________________ ___________________
Student Signature Date
click to sign
signature
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