Financial Aid Office SUNY Plattsburgh 101 Broad Street Plattsburgh, NY 12901-2681
Tel: (518) 564-2072 Toll-Free: (877) 768-5976 Fax: (518) 564-4079 email:
Revised: 12/01/2019 SIGNAT
Student Name: ___________________________ Banner ID or NetID: ____________________________
At least one signature was missing from your 2020-2021 Free Application for Federal Student Aid (FAFSA):
the student signature, the parent signature, or both. We need the missing signature(s) in order to complete
your FAFSA and package you with financial aid, assuming there are no other issues with you r FAFSA.
1. Read the Certification Statement.
2. Sign and date this document in the space provided below. A parent signature is only required for
dependent students, not independent students.
3. Fax or mail this document to the Financial Aid Office.
If you are the student, by signing this application [FAFSA] you certify that you:
(1) will use federal and/or state student financial aid only to pay the cost of attending an institution of
higher education,
(2) are not in default on a federal student loan or have made satisfactory arrangements to repay on a
defaulted federal student loan,
(3) do not owe money back on a federal student grant or have made satisfactory arrangements to repay
money owed back on a federal student grant,
(4) will notify your school if you default on a federal student loan, and
(5) will not receive a Federal Pell Grant for more than one school for the same period of time.
If you are the parent or the student, by signing this application you agree, if asked, to provide information that
will verify the accuracy of your completed form. This information may include your U.S. or state income tax
forms that you filed or are required to file. Also, you certify that you understand that the Secretary of
Education has the authority to verify information reported on this application with the Internal Revenue
Service and other federal agencies. If you sign any document related to the federal student aid programs
electronically using a Federal Student Aid ID (FSA ID), you certify that you are the person identified by the FSA
ID and have not disclosed that FSA ID to anyone else. If you purposely give false or misleading information,
you may be fined $20,000, sent to prison, or both. (OMB # 1845-0001)
A parent signature is only required for students who are considered dependent for financial aid purposes, not
independent students.
Student Ink Signature Date
Parent Ink Signature (required only if student is a dependent) Date
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