Fillable VERIFICATION OF IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE (State University of New York at Plattsburgh)

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VERIFICATION OF IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE (State University of New York at Plattsburgh)

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R
evised: 12/01/2019 IDENT
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: finaid@plattsburgh.edu
VERIFICATION OF IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE FOR 2021-2022
Student Name: ___________________________ Banner ID or NetID: ____________________________
INSTRUCTIONS
1. I
f you, the student, are able to appear in person at the Financial Aid Office at SUNY Plattsburgh, complet
e
t
he Sign at Financial Aid Office section below in the presence of an official of the Financial Aid Office.
2. If you are unable to appear in person at the Financial Aid Office, complete the Sign with Notary section on
t
he opposite page in the presence of a notary. Then, mail this original document (no faxes, scans, or
copies) to the Financial Aid Office along with a copy of the valid government-issued photo identification that
is acknowledged in the notary’s certification.
SIGN AT FINANCIAL AID OFFICE
You, the student, must appear in person at the Financial Aid Office at SUNY Plattsburgh (Kehoe Building, 4
th
Floor). To verify identity, you must present an unexpired valid government-issued photo identification (ID),
such as, but not limited to, a driver’s license, other state-issued ID, or passport. SUNY Plattsburgh will
maintain a copy of your photo ID that is annotated with the date it was received and the name of the official at
the institution authorized to collect your ID. In addition, you must sign in the presence of an official of the
Financial Aid Office, the following:
Statement of Educational Purpose
I
certify that I _______________________ am the individual signing this Statement of Educational Purpose
(Print Student’s Name)
and that the Federal student financial assistance I may receive will only be used for educational
purposes and to pay the cost of attending SUNY Plattsburgh for 2021-2022.
Student Ink Signature Date
Financial Aid Office Date
FAO Reminder = Verify identity on FAA Access - Name ID = first two letters of last name
R
evised: 12/01/2019 IDENT
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: finaid@plattsburgh.edu
VERIFICATION OF IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE FOR 2021-2022
Student Name: ___________________________ Banner ID or NetID: ____________________________
INSTRUCTIONS
1. If you are unable to appear in person at the Financial Aid Office, complete the Sign with Notary section
bel
ow in the presence of a notary. Then, mail this original document (no faxes, scans, or copies) to the
Financial Aid Office along with a copy of the valid government-issued photo identification that is
acknowledged in the notary’s certification.
2. If you, the student, are able to appear in person at the Financial Aid Office at SUNY Plattsburgh, complete
the Sign at Financial Aid Office section on the opposite page in the presence of an official of the
Fi
nancial Aid Office.
SIGN WITH NOTARY
If you, the student, are unable to appear in person at the Financial Aid Office, to verify identity you must
provide the Financial Aid Office with both of the following:
a) A copy of the unexpired valid government-issued photo identific
ation (ID) that is acknowledged in the
notary statement below. Examples include, but are not limited to, a driver’s license, other state-issued ID,
or passport.
AND
b) The original notarized Statement of Educational Purpose provided below (cannot be faxed or scanned).
Statement of Educational Purpose
I certify that I _______________________ am the individual signing this Statement of Educational Purpose
(Print Student’s Name)
and that the Federal student financial assistance I may receive will only be used for educational purposes
and to pay the cost of attending SUNY Plattsburgh for 2021-2022.
Student Ink Signature Date
Notary’s Certificate of Acknowledgement (to be completed by notary)
State of _____________ City/County of ___________ On _________, before me, ___________________,
(Date) (Notary’s name)
personally appeared, ______________________________, and provided to me on basis of satisfactory
(Printed name of signor)
evidence of identification __________________________________________ to be the above-named
(Type of unexpired government-issued photo ID provided)
per
son who signed the foregoing instrument.
WITNESS my hand and official seal ___________________. My commission expires on _____________.
(seal) (Notary signature) (Date)
F
AO Reminder = Verify identity on FAA Access - Name ID = first two letters of last name)
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VERIFICATION OF IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE (State University of New York at Plattsburgh)

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Completed 1 February 2021

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