2017-2018
Social Security Number Resolution
Student ID
Last Name First Name
The Social Security Administration (SSA) did not confirm that the Name, Date of Birth, or Social Security Number
(SSN) you reported on your FAFSA is correct. Please complete this form and return along with a CLEAR COPY of
your Social Security Card to Pasadena City College’s Financial Aid Office.
Student’s Full Name as it appears on your Social Security Card
Last Name First Name
Social Security Number
First Name
Date of Birth
__________________________________________ _______________________________________
__________________________________
_____________________________________ __________________________________
___________________________ Date of Birth________________________________
Father/StepFather’s Full Name as it appears on their Social Security Card
Last Name_____________________________________ __________________________________
Social Security Number___________________________ ________________________________
Mother/StepMother’s Full Name as it appears on their Social Security Card
Last Name_____________________________________ First Name__________________________________
Social Security Number___________________________ Date of Birth________________________________
If the Name, Date of Birth, and/or SSN reported for you or your parent’s on your FAFSA are/is correct, please
contact the SSA at 1-800-772-1213 or
www.socialsecurity.gov
to update your SSA records. Once your records
have been updated, place a check mark in the box to the left, and submit this completed form to Pasadena City
College’s Financial Aid Office along with a CLEAR COPY of your Social Security Card.
I understand that by signing this form I agree, if asked, to provide information that will verify the accuracy of the completed form. I also certify
that I understand that Pasadena City College’s Office of Financial Aid has the authority to verify information on this form with other federal and
state agencies. I further understand that if I purposely give false or misleading information I may be fined up to $20,000, sent to prison, or both.
Student’s Signature_________________________________________ Date______________
Parent’s Signature__________________________________________ Date______________
1570 East Colorado Blvd.L-114, Pasadena, California 91106
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2003
18SOCR
