Fillable FAC19V4D (Howard Community College)

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FAC19V4D (Howard Community College)

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A. Student’s Information
Student’s Last Name Student’s First Name Student’s M.I. Student’s HCC ID Number
B. High School Completion Status
Provide one of the documents below to indicate the student’s high school completion status when the student
begins college in 2019–2020.
A student who is unable to obtain the documentation listed must contact the nancial aid oce.
• A copy of the student’s high school diploma.
• For students who completed secondary education in a foreign country, a copy of the “secondary school
leaving certicate” or other similar document.
• A copy of the student’s nal ocial high school transcript that shows the date when the
diploma was awarded.
• A state certicate or transcript received by a student after the student passed a State-authorized
examination that the State recognizes as the equivalent of a high school diploma (GED test, HiSET,
TASC, or other State-authorized examination).
• A copy of the student’s DD 214, Member 4 copy.
• An academic transcript that indicates the student successfully completed at least a two-year program
that is acceptable for full credit toward a bachelor’s degree.
• For a student who was homeschooled in a state where state law requires the student to obtain a
secondary school completion credential for homeschooling (other than a high school diploma or its
recognized equivalent), a copy of that credential.
• For a student who was homeschooled in a state where state law does not require the student to obtain a
secondary school completion credential for homeschooling (other than a high school diploma or its recog-
nized equivalent), a transcript, or the equivalent, signed by the student’s parent or guardian, that lists the
secondary school courses the student completed and includes a statement that the student successfully
completed a secondary school education in a homeschool setting.
C. CerticationandSignature
I certify that all of the information reported on this worksheet is complete and correct.
The student and one parent must sign this worksheet.
Date:
Student’s Signature
Date:
Parent’s Signature
You must complete Section D on page 2. 
Financial Aid Services
10901 Little Patuxent Pkwy
Columbia MD 21044
443-518-1260; 443-518-4576 (FAX)
naid@howardcc.edu www.howardcc.edu
CR I: FAC19V4D
ImageNow Doc type: UG Finaid Verication
FA Doc Name: V-Verication Forms
Work Flow Main: FAS Document Processing
Sub-queue: Academic Year
Your 2019–2020 FAFSA was selected for review in a process called verication. To verify that you provided
correct information, we will compare your FAFSA with the information on this institutional verication document and
with any other required documents. If there are dierences, your FAFSA information may need to be corrected.
Review of submitted documents can take up to 15 business days.
2019/2020 V4 Dependent Verication Worksheet
WARNING: If you purposely give false or misleading information,
you may be ned, sent to prison, or both.
REST FORM
PRINT FORM
D. StatementofEducationalPurposeandCerticationofIdentity
• This statement must be completed and signed in the presence of an HCC Financial Aid Representative.
• Do not complete form in advance!
HCC ID#
V4–Dependent
Verication of Government-Issued ID
OFFICE USE ONLY: To be completed by HCC Financial Aid Representative:
ID Type: □ Driver’s License □ Non-Driving State ID □ Passport □ Other
ID Number: Expiration date:
FAA Name:
FAA Title:
FAA Signature:
Date:
Statement of Educational Purpose
I certify that I am the individual signing this
Print Student’s Name
Statement of Educational Purpose and that the Federal student nancial assistance I may
receive will only be used for educational purposes and to pay the cost of attending
Howard Community College for 2019-2020.
Student’s Signature
Date
Student’s HCC ID Number
The student must appear in person at Howard Community College’s Financial Aid Services to verify his or
her identity by presenting an unexpired valid government-issued photo identication (ID), such as, but not limited
to, a driver’s license, other state-issued ID, military ID, or passport. The institution will maintain a copy of the
student’s photo ID that is annotated by the institution with the date it was received and reviewed, and the name of
the ocial at the institution authorized to receive and review the student’s ID.
In addition, the student must sign, in the presence of the institutional ocial, the Statement of Educational
Purpose provided below.
2
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FAC19V4D (Howard Community College)

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Completed 23 July 2020

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