1. finance
2. grants, scholarships and financial aid
3. financial aid

2014-2015
Custom Verification Worksheet Instructions
Federal Student Aid Programs
Your 2014-2015 Free Application for Federal Student Aid (FAFSA) was selected for review in a
process called verification. The law says that before awarding Federal Student Aid, we may ask you
to confirm the information you reported on your FAFSA. To verify that you provided correct
information, we will compare your FAFSA with the information on this custom verification worksheet
and with any other required documents. If there are differences, your FAFSA information may need
to be corrected. You and a parent (if applicable) whose information was reported on the FAFSA must
complete and sign this custom verification worksheet, attach any required documents, and submit the
form and other required documents to us. We may ask for additional information. If you have
questions about verification, contact us as soon as possible so that your financial aid will not be
delayed.
If you are unable to provide proof of high school completion or were a homeschooled student, please
contact the Financial Aid Office before completing this form.
Additionally, the Statement of Educational Purpose must be signed in the presence of a Financial Aid
Office staff.
If you take all your classes online, you must provide an original signed and notarized Statement of
Educational Purpose. Contact the Financial Aid Office for more information.
721 Cliff Drive • Santa Barbara, California 93109-2394 • Phone (805) 730-5157 • Fax (805) 564-1893
2014-2015 Custom Verification Worksheet
(complete online, print, and sign)
K00
Last Name
Save
First Name
A. High School Completion Status
Choose one of the following documents to provide that indicate the student's high school completion status when the
student will begin college in 2014-2015:
B. Certification and Signatures
Each person signing this worksheet certifies that all of the information
reported on it is complete and correct. The student and one parent
whose information was reported on the FAFSA must sign and date.
WARNING: If you purposely give false or
misleading information on this worksheet, you
may be fined, be sentenced to jail, or both.
Student's Signature
Date
Parent's Signature
Date
721 Cliff Drive • Santa Barbara, California 93109-2394 • Phone (805) 730-5157 • Fax (805) 564-1893
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First Name
Last Name
C. Identity and Statement of Educational Purpose (To Be Signed at the Institution)
The student must appear in person at SANTA BARBARA CITY COLLEGE to verify his or her identity
by presenting valid government-issued photo identification (ID), such as, but not limited to, a driver's
license, other state-issued ID, or passport. 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 collect the student's ID.
In addition, the student must sign, in the presence of the institutional official, the following:
Statement of Educational Purpose
I certify that I,
, am the individual signing this Statement of
(Print Student's Name)
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 SANTA BARBARA CITY COLLEGE for
2014-2015.
Date
Student's Signature
If the student is an online student and unable to appear in person at SANTA BARBARA CITY
COLLEGE to verify his or her identity, the student must provide:
(a) Statement of Educational Purpose, to be signed with notary
(b) A clear 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 stateissued ID, or passport; and
(c) The original notarized Statement of Educational Purpose provided above.
Notary's Certificate of Acknowledgement
City/County of
State of
On
(Date)
, before me,
(Notary's Name)
personally appeared
,
, and provided to me
(Print Student's Name)
to be the
on basis of satisfactory evidence of identification
(Type of government-issued photo ID provided)
above-named person who signed the foregoing instrument.
WITNESS my hand and official seal
(seal)
(Notary Signature)
My commission expires on
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