If this document is not accessible, contact Disability Services at 910.788.6327, disabilityservices@sccnc.edu, or in A-124.
SOUTHEASTERN COMMUNITY COLLEGE
FINANCIAL AID OFFICE
2020-2021 IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE (To Be Signed at the Institution)
Your 2020-2021 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law
says that before awarding Federal Student Aid, we may ask you to confirm the information you reported on your FAFSA. To verify
that you provided correct information, we will require certain information to be provided to the school. You must complete and sign
this worksheet, and submit the form and other required documents to the school. We may ask for additional information. If you have
questions about verification, contact the Financial Aid Office as soon as possible so that your financial aid will not be delayed.
STUDENT’S NAME: _________________________________ Student ID or SSN: ______________________
The student must appear in person at SOUTHEASTERN COMMUNITY COLLEGE to verify his or her identity by presenting a valid
government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. The
institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received and reviewed
and the name of the official at the institution authorized to collect the student’s ID.
In addition, the student must sign, in the presence of the institutional official, the following English or Spanish Statement:
Statement of Educational Purpose
I certify that I ______________________________________ am the individual signing this
(Print Student’s Name)
Statement of Educational 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
SOUTHEASTERN COMMUNITY COLLEGE for 2020-2021.
ATTENTION: You must sign in person in the Financial Aid Office.
________________________________________________________
(Student’s Signature and Date)
______________________
(Student’s ID Number)
Declaración de Propósito Educativo
Certifico que yo, __________________________, soy el individuo que firma esta
[Imprimir Nombre del Estudiante] Declaración de Finalidad Educativa y que la ayuda financiera federal
estudiantil que yo pueda recibir, sólo será utilizada para fines educativos y para pagar el costo de asistir
a ____________________________________ para 2020–2021.
[Imprimir Nombre de Institución Educativa Postsecundaria]
_____________________________________________________________
[Firma del Estudiante] [la Fecha]
________________________________
[Número de Identificación del Estudiante]
WITNESS:
______________________________________
SCC Financial Aid Staff
______________________________________
Type of Government Issued Photo ID Received
______________________________________
Date
FINANCIAL AID OFFICE USE ONLY
Received Statement and Copy of Valid ID
Received Date: ____________
Received By: ______________
IF YOU ARE UNABLE TO APPEAR IN PERSON AT SCC, YOU MAY COMPLETE THE REVERSE SIDE OF THIS FORM WITH A NOTARY
If this document is not accessible, contact Disability Services at 910.788.6327, disabilityservices@sccnc.edu, or in A-124.
2020-2021 IDENTITY AND STATEMENT OF EDUCATIONAL PURPOSE (To Be Signed With Notary)
STUDENT’S NAME: _________________________________ Student ID or SSN: ______________________
If the student is unable to appear in person at SOUTHEASTERN COMMUNITY COLLEGE to verify his or her identity, the student must
provide:
(a) A copy of the valid government-issued photo identification (ID) that is acknowledged in the notary statement below, such as, but
not limited to a driver’s license, other state-issued ID, or passport; and
(b) The original notarized Statement of Educational Purpose (in English or Spanish) provided
below:
Statement of Educational Purpose
I certify that I _____________________________ am the individual signing this
(Print Student’s Name)
Statement of Educational 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
SOUTHEASTERN COMMUNITY COLLEGE for 2020-2021.
________________________________________________________
(Student’s Signature) (Date)
______________________
(Student’s ID Number)
Declaración de Propósito Educativo
Certifico que yo, __________________________, soy el individuo que firma esta
[Imprimir Nombre del Estudiante]
Declaración de Finalidad Educativa y que la ayuda financiera federal estudiantil que yo pueda recibir,
sólo será utilizada para fines educativos y para pagar el costo de asistir a
____________________________________ para 2020–2021.
[Imprimir Nombre de Institución Educativa Postsecundaria]
_____________________________________________________________
[Firma del Estudiante] [la Fecha]
________________________________
[Número de Identificación del Estudiante]
Notary’s Certificate of Acknowledgement
State of _____________________________________________________________________
City/County of ________________________________________________________________
On today’s date, _____________________, before me, (Notary’s name, __________________________________________,
personally appeared, __________________________________________, and proved to me
(Printed name of signer)
on basis of satisfactory evidence of identification______________________________________ (Type of government-issued photo ID
provided) to be the above-named person who signed the foregoing instrument.
WITNESS my hand and official seal
________________________________________ (Notary signature and Seal)
My commission expires on _________________________
(Date)
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