WARNING: If you purposely give false or misleading information, you may be fined, sent to prison or both.
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FA20CINM
OFFICE OF STUDENT FINANCIAL AID
ROBESON COMMUNITY COLLEGE
Student Center Building 13
PO Box 1420
Lumberton, NC 28359
T 910.272.3352 Email: finaid@robeson.edu
F 910.272.3314 Website: https://www.robeson.edu/fa/
2020-2021 Inmate Status
Form
Student’s Name: _____________________________________________ Student ID: ____________________
Address: __________________________________________ City/State/Zip____________________________
Phone #: ______________________________________ Email: ______________________________________
According to the information on your 2020-2021 FAFSA application for Financial Aid, you were an inmate in
jail or prison. We need to verify this information. Please submit all requested documentation to the Financial
Aid Office as soon as possible upon receiving this letter.
Please mark one of the following below:
Yes, I am currently an inmate.
Name of Prison or Jail: ______________________________________________________
Address of Prison or Jail: ____________________________________________________
Expected release date: ______________________________________________________
No, I am not currently an inmate.
Certification:
I certify that the information is true and correct to the best of my knowledge and belief. I understand that RCC has the right
to require additional proof of the information provided on this form. I agree to submitting further documentation if
requested.
______________________________________ ___________________
Student Signature Date
click to sign
signature
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