Office of Financial Aid
Hepburn Hall, Room 215 |201-200-3173| 2039 John F. Kennedy Boulevard | Jersey City, NJ 07305
Please log into your Gothic
Portal and upload form to
2019-2020 Identity and Statement of Educational Purpose
(To Be Signed in the Presence of a Notary)
If the student is unable to appear in person at New Jersey City University to verify his or her identity,
the student must provide to the institution:
(a) A copy of the unexpired valid government-issued photo identification (ID) that is acknowledged in
the notary statement below, or that is presented to a notary, such as, but not limited to, a driver’s
license, other state-issued ID, or passport; and
(b) The original Statement of Educational Purpose provided below, which must be notarized.
I certify that I ______________________________________ am the individual signing
Print Student’s Name)
this Statement of Educational Purpose and that the Federal student financial assistance
I may receive will only be used for educational purposes and to pay the cost of attending New Jersey City
University for 2019-2020 Academic Year.
Notary’s Certificate of Acknowledgement
State of _____________________________________________________________________
City/County of ________________________________________________________________
On_____________________, before me, __________________________________________,
(Date) (Notary’s name)
personally appeared, __________________________________________, and proved to me
(Printed name of signer)
on the basis of satisfactory evidence of identification _______________________________________
(Type of unexpired government-issued photo ID provided)
to be the above-named person who signed the foregoing instrument.
WITNESS my hand and official seal
(seal) ________________________________________
(Notary signature)
My commission expires on _________________________
Certification and Signature
Each person signing below certifies that all of the information reported is complete and correct.
WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or both.
________________________________________ ________________________
Student’s Signature (Required) Date
Student ID Number