* This form must be submitted by the priority deadline to ensure a determination of aid eligibility before the Fee Due Date. Students may submit
the form after the priority deadline, but EFSC cannot guarantee that late submissions will be notified of aid eligibility prior to the Fee Due Date.
04/06/20
20V4D
FA Verification
2019
-20 Dependent Student
Verification Form
V4 Custom Verification Group
Y
our 2019-2020 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification.
About 30% of all FAFSA filers are selected for verification, which requires the school to collect documentation to review
the accuracy of FAFSA information. EFSC cannot award federal financial aid until this worksheet is processed.
Priority Deadlines*: Fall 2019 07/18/19 | Spring 2020 11/25/19 | Summer 2020 04/23/20
A. Student Information
B#
Last Name First Name M.I. Student ID
B. High School Completion Status
Please indicate your high school completion status when you begin college in 2019–2020:
I received or will have received a high school diploma.
I completed or will have completed secondary education in a foreign country and have a copy of the
“secondary school leaving certificate” or other similar document.
I have or will have passed a state authorized examination (GED test, HiSET, TASC, or other State-authorized
examination).
I completed or will have completed at least a two-year program that is acceptable for full credit toward
a
b
achelor’s degree.
I was homeschooled.
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
2
C. Identity and Statement of Educational Purpose
You must verify your identity by mailing or uploading a copy of a valid government-issued photo identification
(ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. Expired documents will
only be accepted if the document expired after March 1, 2020.
Please specify the document you are submitting:
D
river’s License
State-issued ID
Passport
Other (please specify): _______________________________________
In a
ddition, you must sign the Statement of Educational Purpose provided below.
Statement of Educational Purpose
I ce
rtify that I _________________________________________________________
am the individual signing this
(Print Student’s Name)
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 Eastern Florida State College for 2019-2020.
_______________________________________
_______________
(Student’s Signature) (Date)
_______________________________________
(Student’s EFSC B Number)
EFSC Office of Financial Aid
www.easternflorida.edu/go/aid | (321) 433-7339 | finaid@easternflorida.edu
3
D. Certification and Signatures
Each person signing below certifies that all of the information
reported is complete and correct. The student and one parent
whose information was reported on the FAFSA must sign and date.
Student’s Original Signature (cannot be signed electronically) Date
Parent’s Original Signature (cannot be signed electronically) Date
E. Document Submission
You may submit this document by the following methods:
1. EFSC DOCUMENT DROPBOX (RECOMMENDED)
Print and complete this document (including the original signatures), scan the document, and upload the
document via the Document Dropbox in myEFSC.
2. BY MAIL
Mail your document to the Office of Financial Aid at:
Eastern Florida State College
Office of Financial Aid
Building 2, Room 209
1519 Clearlake Road
Cocoa, FL 32922
QUESTIONS?
Financial Aid Specialists are available by phone at 321-433-7339 and via e-mail at finaid@easternflorida.edu.
Eastern Florida State College is committed to equal access/equal opportunity in its programs, activities, and employment.
For additional information, visit Eastern Florida State College: easternflorida.edu/go/equity.
WARNING: If you purposely give
false or misleading information on
this worksheet, you may be fined,
sent to prison, or both.
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome