Solo 510 14 15 Identity And Statement Of Educational Purpose Form Notarized Ysh
User Manual: Solo 510
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East Carolina University Office of Student Financial Aid 2014-2015 Identity and Statement of Educational Purpose (To Be Signed In Front of a Notary) Please complete and sign in the presence of a notary. Return this form via mail to: Office of Student Financial Aid, East Carolina University, 2103 Old cafeteria Complex, Mail Stop 510, Greenville, NC 27858. This form cannot be faxed or emailed. If you have any questions, please contact our office at 252-328-6610. Failure to complete and return this form will delay the processing of your financial aid. Student Name: _____________________________ ECU (Banner) ID: ___________________ If the student is unable to appear in person at East Carolina University, 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 _________________________________________ for 2014-2015. (Name of Postsecondary Educational Institution) _________________________________________ (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 2014–2015. [Imprimir Nombre de Institución Educativa Postsecundaria] _____________________________________________ [Firma del Estudiante] ________________________________ [Número de Identificación del Estudiante Page 1 of 2 ________________ [la Fecha] Notary’s Certificate of Acknowledgement State of ________________________________________________________________________ City/County of ___________________________________________________________________ On_____________________, before me, ____________________________________________, (Date) (Notary’s name) personally appeared, ____________________________________________, and provided 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 (seal) ________________________________________ (Notary signature) My commission expires on _________________________ (Date) Page 2 of 2
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