VWD4E/VWI4E
2019-20 Verification Worksheet Form 4
Student ID Number: S
Student Name:
Phone Numbe r:
Form must be completed in blue or black ink. Failure to accurately complete this form may result in a delay
of processing or change of financial aid eligibility. Additional documentation may be requested. Read
instructions carefully before completing.
Section 1: High School Completion Status
Please submit documentation to verify you have completed a high school education. Acceptable
documentation can include:
A high school diploma or a copy of an official high school transcript. Transcripts must verify graduation
completion date
GED certificate or transcript
A transcript that indicates that you have successfully completed at least a two-year program that is acceptable
for full credit toward a bachelor’s degree at any participating school
Home school credential or transcript
If high school completed in foreign country, a copy of thesecondary school leaving certificate” or similar
document
Type of documentation submitted:
Designated institutional official:
(School official’s printed name)
Section 2: Identity
MUST BE COMPLETED & SIGNED AT THE FINANCIAL AID OFFICE
If unable to appear in person at the Financial Aid Office, you must complete this section with a notary
You must appear in person at
(Name of institution)
Financial Aid Office to verify your
identity by presenting a valid unexpired government-issued photo identification (ID), such as, but not limited
to, a driver’s license, other state-issued ID, or passport. The institution will maintain a copy of your photo ID.
Type of documentation submitted:
Designated institutional official:
(School official’s printed name)
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VWD4E/VWI4E
Student ID Number: S
Section 3: Statement of Educational Purpose
MUST BE COMPLETED & SIGNED AT THE FINANCIAL AID OFFICE
If unable to appear in person at the Financial Aid Office, you must complete this section with a notary
In addition, you must sign, in the presence of the institutional official, the following:
I certify that I
(Student’s printed name)
am the individual signing 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
(Name of institution)
for 2019-2020.
Student Signature: Date:
Notary Section Instructions: Please Read
This section should only be completed if you are unable to appear in person at the institution with a designated official.
This form (the original on which the seal is visible) should be mailed to the Financial Aid Office at your institution along
with the copy of the government-issued identification and high school documentation.
Notary’s Certificate of Acknowledgement
State of City/County of
On , before me
(Date) (Notary’s name)
Personally appeared and proved to me on the basis of
(Printed name of signer)
Satisfactory evidence of Identification to be the above-named
(Type of unexpired government-issued ID provided)
Person who signed the foregoing instrument.
My commission expires on , 20
Notary (Print):
Notary (Signature):
(Seal)
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