Submit this completed form and all supporting documents to Lamar State College Port Arthur Financial Aid Office using your preferred method.
Mail: LSCPA Office of Financial Aid ▪ PO Box 310 ▪ Port Arthur, TX 77641 Drop off: 304 Student Center
Revised 10/21/2019
IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE
Student Information
Name____________________________________________________ ID # __________________________
Directions
A. The student must appear in person at Lamar State College Port Arthur to 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
institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received and
reviewed, and the name of the official at the institution authorized to receive and review the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the Statement of Educational Purpose provided
below.
B. If the student is unable to appear in person at Lamar State College Port Arthur 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.
Statement of Educational Purpose
I certify that I, _______________________________________________________________________, am the individual
(Printed Student’s Name)
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 Lamar State College Port Arthur for 2020-2021.
______________________________________________________________ ________________ _____________________
Student’s Signature Date Student’s ID Number
Completed by LSCPA Financial Aid Office (if student appears in person at Lamar State College Port Arthur)
________________________________ ________________________ _______________________
ID TYPE ID Number EXP Date
___________________________________________________ __________________________________________________________ _________________
Financial Aid Staff Financial Aid Staff Signature Date
Notary’s Certificate of Acknowledgement (If student is unable to appear in person at Lamar State College Port Arthur)
State of ____________________________________________City/County of __________________________________________
On _________________________, before me, ____________________________________________, personally appeared,
(Date) (Notary’s name)
____________________________________________, and proved to me on basis of satisfactory evidence of identification
(Printed name of signer)
________________________________________ to be the above-named person who signed the foregoing instrument.
(Type of government-issued photo ID provided)
WITNESS my hand and official seal (seal)
_______________________________________________
(Notary signature)
My commission expires on ________________________
