CITIZENSHIP AND IMMIGRATION
This form is for the collection of DHS or other U.S. citizenship/nationality documents from students to satisfy federal student aid
requirement to verify citizenship or eligible noncitizen status. If you are unable to present your documents in person at a
Brandman University campus, please use the notary version of this form available on the Brandman.edu forms center.
I certify that I, _______________________________________________________________, am the individual signing this
(Print student’s full name)
statement, and I am providing both (1) a copy of my documents along with (2) a copy of a valid government-issued photo
identification card such as a driver’s license or State ID.
NOTE: It is unlawful to photocopy Military ID, therefore it may not be used for this
ID(Driver’s license or State ID)
EXPIRATION DATE OF VALID PHOTO ID
ISSUING AUTHORITY OF VALID PHOTO ID
(state or federal)
NAME OF CITIZENSHIP AND/OR IMMIGRATION
EXPIRATION DATE (IF ANY) OF CITIZENSHIP AND/OR
I certify that the attached documents and government issued photo identification are the true, exact, and complete copies of the originals issued to
me. I understand that providing false or misleading information or documents is punishable by fine or imprisonment and may make me liable for
repayment of any funds received on the basis of the information and documents I have provided.
________________________________ ___________________________ ______________________
Student’s Handwritten Signature Student’s ID Number Date
Brandman University Official Use
On_____________________, before me, ____________________________________________,
(Date) (Official’s name)
The above student personally appeared before me and provided to me satisfactory evidence of identification.
(Type of government-issued photo ID provided)
(Brandman University Campus)
Please send this form and the above referenced copied documents to the Brandman Financial Aid Office