(WHITE) 15-16 Signature Page with Missing Parent Info
Financial Aid Office P.O. Box 804 Spindale, NC 28160
Corrections to FAFSA Signature Page 2015-2016
Student’s Name Student ID Number
Step One: Read the following.
Students: By signing a signature page, 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 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.
Students and Parents: By signing a signature page, you agree if asked:
1. to provide information that will verify the accuracy of your completed form.
2. to provide U.S. or state income tax transcript that 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.
Step Two: Sign below unless otherwise noted.
Student Signature: ________________________________________ Date: _______________
Parent Signature: _________________________________________ Date: _______________
If parental information is provided on the FAFSA, at least ONE parent whose information is provided must
sign.
Step Three: Return the signature page to Financial Aid Office.
This signature page is for FAA Records only.
PLEASE PROVIDE PARENTAL INFORMATION ON THE BACK OF THIS FORM
(WHITE) 15-16 Signature Page with Missing Parent Info
Parental Information Worksheet
1. What is your parents’ marital status as of today?
Married or remarried Single Divorced or separated Widowed
2. Month and year your parents were married, separated, divorced or widowed:
___/___/_____
3. What is your father’s (or stepfather’s) Social Security Number?
____-___-_____
4. What is your father’s (or stepfather’s) last name?
____________________________
5. What is your father’s (or stepfather’s) first initial of their first name?
_____
6. What is your father’s (or stepfather’s) date of birth?
___/___/_____
7. What is your mother’s (or stepmother’s) Social Security Number?
____-___-_____
8. What is your mother’s (or stepmother’s) last name?
____________________________
9. What is your mother’s (or stepmother’s) first initial of their first name?
_____
10. What is your mother’s (or stepmother’s) date of birth?
___/___/_____
11. What is your parents’ state of legal residence?
______
12. Enter the date of legal residency for the parent who has lived in the state the longest, if
it was not before January 1, 2009.
____/____/______