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This 2-page document outlines the process for confirming a student's identity and statement of educational purpose for financial aid purposes. It provides instructions for completing the process either in person at the institution by presenting valid photo ID, or remotely in the presence of a notary. If completing remotely, the student must provide a copy of their photo ID and an original notarized statement of educational purpose affirming their intent to use financial aid only for educational expenses.

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Melinda R. Francisco
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28 views2 pages

2324SEP

This 2-page document outlines the process for confirming a student's identity and statement of educational purpose for financial aid purposes. It provides instructions for completing the process either in person at the institution by presenting valid photo ID, or remotely in the presence of a notary. If completing remotely, the student must provide a copy of their photo ID and an original notarized statement of educational purpose affirming their intent to use financial aid only for educational expenses.

Uploaded by

Melinda R. Francisco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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2023-2024 Identity and Statement of Educational Purpose

FRANCISCO MELINDA R A01478421


Student's Last Name Student's First Name MI ID Number

mfrancisco3@mail.pima.edu 5202746750 09/11/1978


Student's Email Address Student's Phone Number Student's Date of Birth

Identity Confirmation and Statement of Educational Purpose is ONLY to be completed in person at the
Institution (step 1) or in front of a Notary (step 2).

The form is two pages and the original must be provided to the school.

1) Able to appear in person at the school:

Identity and Statement of Educational Purpose

(Complete this section and the Statement of Educational Purpose provided on page 2)

The student must appear in person at Pima Community College to verify his or her identity by presenting an unexpired valid
government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport (Military
IDs are not acceptable due to limitations on making copies). 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
receive and review the student’s ID.

2) Unable to appear in person at the school, complete with a notary:

Identity and Statement of Educational Purpose

(Complete this section and the Statement of Educational Purpose provided on page 2 only if unable to sign in
person at the institution)

If the student is unable to appear in person at Pima Community College to verify his or her identity, the student must provide to the
institution:
a. A copy of the unexpired valid government-issued photo identification (ID) that is acknowledged in the notary statement below,
or that is presented to a notary, such as, but not limited to, a driver’s license, other state-issued ID, or passport (Military IDs
are not acceptable due to limitations on making copies); and
b. The original Statement of Educational Purpose provided below, which must be notarized.

mail to the following address:


Pima Community College
4905B East Broadway Blvd.
Tucson, AZ 85709-1110

Please continue to page 2


2023-2024 Identity and Statement of Educational Purpose
FRANCISCO MELINDA R A01478421
Student's Last Name Student's First Name MI ID Number

Instruction to notary: If the notary statement appears on a separate page than the Identity and Statement of Educational
Purpose, it must include:

1. a clear indication that the Statement of Educational Purpose was the document notarized and
2. a description of the unexpired valid government-issued photo ID presented to the notary

Statement of Educational Purpose

I certify that I, _________________________________________________________________________________________,


(Print Student's Name)
am the individual signing this 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 Pima Community College for 2023-2024.

A01478421
(Student's Signature) (Date) (Student's ID Number)

(Financial Aid Administrator's Signature) (Date)

Notary's Certificate of Knowledge

State of _______________________________ City/County of ____________________________ On ___________________

before me, _____________________________________ personally appeared, ____________________________________,


(Notary's Name) (Printed name of signer)
and proved to me 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) (Date Commission Expires)

(Seal)

Return this original form with the copy of your unexpired valid government-issued photo identification (ID) acknowledged in the
notary statement to your school's financial aid office. You must return all pages of this document.

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