STATEMENT OF EDUCATIONAL PURPOSE & PROOF OF
IDENTITY 2019-20
Name __________________________________________________ Student ID (700 #) ___________________
Phone ____________________________________ Email ____________________________________________
THE FEDERAL GOVERNMENT HAS REQUESTED THAT, YOU, THE STUDENT, SUBMIT THIS STATEMENT TO THE FINANCIAL
AID OFFICE. PLEASE COMPLETE ONLY ONE OF THE TWO SECTIONS BELOW. THIS FORM MUST BE SUBMITTED IN
PERSON OR BY MAIL. IT CANNOT BE FAXED OR EMAILED.
To be
submitted IN PERSON at the CMU Financial Aid Office in the presence of a Financial Aid Counselor
1) The student must appear in person at the CMU Financial Aid Office and verify his/her identity by presenting an unexpired valid
government-issued identification (ID) such as, but not limited to, a driver’s license, other state-issued ID or passport.
2) In addition, the student must sign, in the presence of a CMU Financial Aid Counselor, the following statement of educational
purpose:
I certify that I ________________________________________________ am the individual signing this Statement of Educational
(Print Student’s Name)
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 Colorado Mesa University for 2019-20.
Student Signature _______________________________________________________ Date________________________
Financial Aid Counselor Signature __________________________________________________________
To be
submitted BY MAIL to the CMU Financial Aid Office if the student is unable to appear in person. This information
CANNOT be faxed or emailed.
1) The student must mail this form with a copy of an unexpired valid government-issued photo identification (ID) such as, but not
limited to, a driver’s license, other state-issued ID or passport that is acknowledged in the notary statement below.
2) In addition, the student must sign, in the presence of a Notary Public, the following statement of educational purpose:
I certify that I ________________________________________________ am the individual signing this Statement of Educational
(Print Student’s Name)
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 Colorado Mesa University for 2019-20.
Student Signature ____________________________________________________ Date___________________________
3) Notary’s Certificate of Acknowledgement:
State of _____________________________________ City/County of________________________________________________
On this date _________________________, before me, ___________________________________________ personally appeared,
(Notary’s name)
_________________________________________, and provided 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_______________________________________
Date my commission expires______________________________
If you purposely give false or misleading information you may be fined, be sentenced to jail or both.
