Citizenship Verification Form printable pdf download

CLEAR

2016-2017 CITIZENSHIP STATUS VERIFICATION FORM

Student Last Name:

RETURN TO:

CAL POLY

Student First Name:

FINANCIAL AID OFFICE

SAN LUIS OBISPO, CA 93407-0201

FAX: (805) 756-7243

Phone #

EMPL ID#:

EMAIL: financialaid@calpoly.edu

IMPORTANT: Submit as soon as possible. Aid will not disburse until all items are submitted and reviewed. Once all items are submitted, allow 3-6

weeks for review. If awarded FWS, SEOG, or Perkins, documents must be submitted no later than June 30, 2016 to avoid potential cancelation of those

funds. In all circumstances, for any aid, documents must be submitted prior to the last day of a student’s enrollment at Cal Poly.

Your Financial Aid Award cannot be finalized or released until you provide the original or a photocopy of appropriate

citizenship verification (see below). NOTE: All documents must be clearly legible, including pictures. When providing a

photocopy, do not downsize (reduce) your copy.

SIGN and DATE:

I certify that the citizenship documentation submitted with this form is true and accurate.

False statements or misrepresentation will be cause for denial, reduction, withdrawal

and/or repayment of financial aid.

________________________________________________

_________________

Student Signature (Required. No electronic signature.)

Date

ELIGIBLE CITIZEN

While older versions of these two certificates advise the holder not to photocopy them, the Department of Homeland

Security (DHS) has confirmed that the certificates may be photocopied for lawful purposes (newer versions of the form

will include this information). It is permissible for a school to photocopy these certificates for its records.

Must have student’s name and application number, certificate number, and date

“Certificate of Citizenship”

it was issued.

Form N-560 or N-561

Must have student’s name and petition number, certificate number, DHS Alien

“Certificate of Naturalization”

registration number, name of the court, and date where naturalization occurred.

Form N-550 or N-570

Must have embossed seal reading “United States of America” and “State

“Certificate of Birth Abroad”

Department.” The FS-240 is titled “Report of Birth Abroad.”

Form FS-545, DS-1350, or FS-240

Must indicate U.S. Citizenship or Non-Citizen National.

U.S. Passport

Must indicate birth in one of the U.S. States or eligible territories.

Birth Certificate

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FCIT

Citizenship Verification Form

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