Fillable Citizenship Verification printable pdf download

CITZN

Please complete this form online, then print and sign using blue or black ink.

STUDENT NAME: __________________________________________

WIN: ____________________________________________________

WMU Student Financial Aid

1903 W Michigan Ave

DAYTIME PHONE: __________________________________________

Kalamazoo MI 49008-5337

ADDRESS: ________________________________________________

(269) 387-6000

CITY, STATE, ZIP: ___________________________________________

finaid-info@wmich.edu

CITIZENSHIP VERIFICATION

We have been asked by the U.S. Department of Education to verify your citizenship status. Please complete the following

sections, sign and bring this form to Bronco Express. Your completed form must be received in our ofﬁ ce at least 30 days prior

to your last date of enrollment for the academic year you are requesting ﬁ nancial aid.

Email Address: _____________________________________________ Nationality: _____________________________

My citizenship status is (Please select one and present the required original documentation in person):

____ U.S. Citizen. Please present a copy of your U.S. birth certiﬁ cate and a valid Social Security card or your original

U.S. Passport.

____ Naturalized Citizen or U.S. National. Please present one of the following original documents:

U.S. Passport, U.S. Passport Card, Certiﬁ cate of Birth Abroad (FS-240, FS-545, or DS-1350), Certiﬁ cate of Citizenship (N560,

N561), or Certiﬁ cate of Naturalization (N550, N570).

* ____ U.S. Permanent Resident. Please present one of the following original documents:

Your Alien Registration Receipt / Resident Alien / Permanent Resident / Conditional Resident card (I-151, I-551); Foreign

passport with I-551 endorsement; or Arrival / Departure Record I-94 with I-551 endorsements.

* ____ Other eligible non-citizen. Refugee; Cuban-Haitian Entrant; Conditional entrant; Asylee, or Indeﬁ nite / Humanitarian

Parolee. Please present your original Arrival/Departure Record (I-94).

If you select this item, we will send your documents to the U.S. Citizenship and Immigration Services (USCIS) or contact Department of

Health and Human Services for veriﬁ cation of your status. It can take up to eight weeks for USCIS to respond to us.

If you are a citizen of Palau, the Marshall Islands, the Federated States of Micronesia, or a Canadian Born Native American; or

a Victim of Human Trafﬁ cking (or a qualifying relative, spouse or child); or a Battered Immigrant – Qualiﬁ ed Alien, please contact

ﬁ nancial aid to arrange a meeting with a Financial Aid Counselor. We cannot proceed with your ﬁ nancial aid application until

your citizenship veriﬁ cation is complete. Many ﬁ nancial aid programs have speciﬁ c deadlines and delays in processing may

result in a reduction or loss of potential ﬁ nancial aid awards. Be sure to include your name and WIN on any documents you

submit. If you have any questions or need assistance, please contact Bronco Express at (269) 387-6000.

STUDENT SIGNATURE: _____________________________________________________________ DATE: _______________________

ORIGINAL DOCUMENT REVIEWED BY: _________________________________________________ DATE: _______________________

Return your completed form to Bronco Express on the lower level of the Bernhard Center. You may also email or mail to the address above.

Be sure to include your name and WIN on all pages. Missing information may delay the processing of ﬁ nancial aid.

Citizenship Verification