FORM EDPURP - IDAHO STATE UNIVERSITY 19-20
IDENTITY & STATEMENT OF EDUCATIONAL PURPOSE
The federal government is requiring that we receive this completed form from you
either in person or by mail with notary signature. As a result, you must return the
information requested on this form as directed or you will not be considered for federal
financial aid. Please return this completed form with attachments, if applicable, to:
Office of Financial Aid, Idaho State University, Museum Building, Room 337
921 S 8
th
Ave, Stop 8077, Pocatello, ID 83209-8077
Phone: (208)282-2756 Fax: (208)282-4755 Email: finaidem@isu.edu
Web: https://www.isu.edu/financialaid/forms/
University Place, Bennion Student Union Building, Student Services Office
1784 Science Center Dr, Idaho Falls, ID 83402 Phone: (208)282-7704
EDPURP-20
*Student Name:
(Use blue or black ink) Last First M.I.
*ISU ID: *Last 4 Digits of Social Security #:
(Find under Academic Tools tab on BengalWeb) *Required
IN PERSON VERIFICATION
- The student must (1) appear in person at Idaho State University
and (2) verify his or her identity by presenting an
unexpired valid government-issued photo identification (ID), such as but not limited to a driver’s license, other state-
issued ID, or passport. The student must also (3) complete this form including the identification section above along
with the Statement of Educational Purpose section and Certification section below.
- Idaho State University
will maintain a copy of the student’s photo ID that is annotated with the date it was received
and the name of the official at the institution authorized to collect the student’s ID.
NOTARY VERIFICATION (i.e. not in person)
- If student is unable to appear in person at Idaho State University
to verify his or her identity, the student must (1)
provide a copy of unexpired valid government-issued photo identification (ID) that is acknowledged in the notary
statement below, such as but not limited to a driver’s license, other state-issued ID, or passport (attach copy to this
completed form); (2) contact a notary to complete the Notary’s Certificate of Acknowledgment section below; (3)
complete this form including identification section above along with the Statement of Educational Purpose section and
Certification section below; and (4) mail this completed form (original) and attachments to the address above.
STATEMENT OF EDUCATIONAL PURPOSE
I certify that I
am the individual signing this
(Print Student’s Full 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 Idaho State University
for 2019-20.
NOTARY’S CERTIFICATE OF ACKNOWLEDGMENT
State of
City/County of
On , before me,
(Date - format: mm/dd/yyyy) (Print Notary’s Full Name)
personally appeared, , & provided to me on basis of satisfactory evidence of
(Print Student’s Full Name)
identification to be the above-named person who signed forgoing instrument.
(Type of government-issued photo ID provided)
WITNESS my hand and official seal
(Notary Signature)
(seal)
My commission expires on
(Date format mm/dd/yyyy)
CERTIFICATION: The person signing below certifies that all of the information reported is complete and correct.
Student Signature: Date:
WARNING: If you purposely give false or misleading information, you may be fined, sent to prison, or both.
(v. 12/12/2018) (S:\20_Forms\formEDPURP.wpd)
Please fill in blanks, print, sign & return
Press tab or shift-tab to move between fields
