VERIFICATION WORKSHEET - V4
2021-2022
FEDERAL STUDENT AID PROGRAMS
A. Student Information
Last Name First Name M.I. Student ID# or Social Security Number
Address (include Apt No.) Phone Number
City State Zip Email
B. High School Completion Status
Provide one of the following documents that indicate the student’s high school completion status when beginning
college in 2021-2022.
A copy of the student’s high school diploma
A copy of the student’s final ocial high school transcript that shows the date when the diploma was awarded
A copy of the student’s General Educational Development (GED) certificate or GED transcript
C. Documentation of Identity/Statement of Educational Purpose
This section must be completed either in the presence of Financial Aid Sta or Public Notary.
In order to complete the verification process, you will need to appear in person at Southeast Technical College and
present your government issued ID (such as a driver’s license, military ID, passport) and this verification worksheet to an
institutionally authorized Financial Aid sta member. The Financial Aid sta member must validate the statement below
at the time of submission by maintaining a copy of your photo ID and by providing a signature and date.
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 Southeast Technical College for 2021-2022.
Student’s Signature Date Financial Aid Sta’s Signature Date
If you cannot appear in person to submit this verification worksheet, you will need to provide a copy of your government
issued photo ID and this verification worksheet notarized by a public notary.
Notary’s Certificate of Knowledge
State of City/County of on before me,
personally appeared, and provided to me on basis of satisfactory
evidence of identification
(Printed Notary’s Name) (Printed Student’s Name)
to be the above named person who signed the foregoing instrument.
(Type of Government Issued
Photo ID Provided)
WITNESS my hand and ocial seal
(Notary’s Signature) (Date Commission Expires)
(Seal)
WARNING: If you purposely give false or misleading information on this worksheet, you may be fined, sentenced to jail,
or both.
SOUTHEASTTECH.EDU
Updated: December 2, 2020
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
click to sign
signature
click to edit
![]()
