RETURN TO
Office of Financial Aid:
Wallace State Community College
Hanceville AL 35077

(256) 352-9137  
(256) 352-8228 (FAX)

NAME OF FINANCIAL AID APPLICANT (Print)  

 ________________________________________                   
  Last                        First                Middle

  ______________________________
                       Social Security number

CITIZEN AND ELIGIBLE NON-CITIZEN VERIFICATION

To receive financial aid, federal law requires the student must be either a United States citizen or an eligible non-citizen. So that we can verify your status, please complete the certification statement below and attach clear photocopies of the indicated documentation. Please note that your documents will be submitted by WSCC to the Immigration and Naturalization Service for confirmation. Please check the appropriate box below.

_____   CITIZEN BORN IN THE UNITED STATES      PLACE OF BIRTH ____________________________

_____    CITIZEN NOT BORN IN THE UNITED STATES
· Attach a copy of your form FS-240: "Report of Birth Abroad of a U.S. Citizen bearing the embossed seal including the words "United States of America" and "State Department"; or
· Attach a copy of your Certificate of Citizenship; or
· Attach a copy of your Certificate of Naturalization; or
· Attach a copy of your U.S. Passport. 

_____NON-CITIZEN NATIONALS (natives of American Samoa or Swain's Island), PERMANENT RESIDENTS OF THE NORTHERN MARIAN ISLANDS OR THE TRUST TERRITORY OF THE PACIFIC ISLANDS: (eligibility limited to grant aid)
· Attach a copy of your U.S. Birth Certificate or Passport

_____U.S. PERMANENT RESIDENTS
Your name on immigration documents:___________________________ A#________________
· Attach copies of both sides of your Alien Registration Receipt Card (I-151, I-551 or I-551C); or
· Attach a copy of your passport, valid through first day of classes, stamped "Processed for I-551. . ." showing the copy of the picture identification page; or
· Attach a copy of your Departure Record (Form I-94) valid through the first day of classes, stamped "processed for I- 151. . . " showing the expiration date, or stamped "Temporary form I-551 " showing the expiration date. Include a copy of the picture identification page.

_____OTHER ELIGIBLE NON-CITIZENS
Your name on immigration documents:____________________________ A#_______________
· Attach a copy of your "Arrival-Departure Record" (Form I-94) with a stamp indicating one of the following: A. "Refugee" B. "Asylum Granted" C. "Indefinite Parole" and/or "Humanitarian Parole" D. "Cuban-Haitian entrant, Status Pending" 

NOTE: You are INELIGIBLE to receive federal student aid if you are:
· An applicant for permanent resident status and not in a category listed above;
· A students with an F1 or F (student visa), Jl or J2 (exchange visitor) or L or G series visa;
· A student with a Card I-688, I-688A, I-688B (Employment Authorization)
· An applicant under the "Voluntary Departure Under the Family Unity Program": (effective 1997-98)
· Undocumented.

  The information given above is correct to the best of my knowledge.
   __________________________________________________________________________   
   Signature 		______________________
   Date

 

Forms Updated 8 July, 2003