UMGC Office of Financial Aid | 3501 University Boulevard East, Adelphi MD 20783 USA
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Form: Certification of Original Documents
Student’s ID #: S Student’s Name: _____________________________________
Please scan and submit this completed form at
The Financial Aid Oce has received your Free Applicaon for Federal Student Aid (FAFSA) and has
determined that addional informaon is needed regarding your cizenship / residency status.
Instructions Page 1: Complete the chart by listing your valid government-issued photo ID (example: Driver’s License,
State Identification Card, etc.). Please note: UMGC cannot accept Military ID card copies per Title 18, U.S. Code, Part I,
Chapter 33, Section 701. Once filled out, please make a copy of the front side of your government-issued ID in the box
provided. The identification used in this section cannot duplicate that of the required document on page 2.
Type of Valid (non- Expired) Photo ID
Expiraon Date of Valid Photo ID
Issuing Authority of Valid Photo ID
Copy of Valid Government-Issued ID
Instrucons Page 2: Check the box of the type of original document you are subming and list the expiraon
date next to the item if applicable. Please make a copy of the coordinang document in the box below.
I cerfy that I, ____________________________________________, am the individual signing this statement
(print full name)
and I am providing copies of my cizenship and/or immigraon documentaon and a separate valid government-
issued photo idencaon card bearing my portrait (or likeness). I cerfy that the aached documents and
government-issued photo idencaon are the true, exact, and complete copies of the originals issued to me.
Student’s Signature __________________________________________________ Date __________________
(must be signed by hand, not typed)
UMGC Office of Financial Aid | 3501 Univers
ity Boulevard East, Adelphi MD 20783 USA
United States Passport, Expiraon Date (if applicable) _________________________
Cercaon of Naturalizaon or Birth Cercate
Permanent Resident Card (I-551; Green Card), Expiraon Date (if applicable)______________________
U. S. Passport stamped “processed for I-551”
Arrival/Departure Record (I-94 or I-94A) stamped with “Processed for I-551”, Expiraon Date ________________
Arrival/Departure Record (I-94) with designaon of Refugee, Asylum Granted, Parolee, Cuban-Haian Entrant or
T-Visa holder, Expiraon Date (if applicable) ______________________
Other _________________________, Expiraon Date (if applicable) ___________________
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