FA-Citizenship Status Confirmation Form

2025-26 Citizenship Status Confirmation Form

Financial Aid Office: 902 Herring Ave PO Box 4305 Wilson, NC 27893 Phone (252) 291-1195 Fax (252) 243-7148
Student Name

First NameLast Name
Student ID
Email
example@example.com
The U.S. Department of Education requires that we verify your citizenship status. Please submit the required original documentation in person. If you cannot present the documentation in person, you may send it along with the affidavit.
Status*

U.S. CitizenU.S. Naturalized CitizenU.S. Permanent Resident (I-94 designated as "Refugee"; "Asylum Granted". "Parolee" or "Cuban-Haitian Entrant"; or "Conditional Entrant")Other eligible non-citizenVictim of Human Trafficking or Battered Immigrant-Qualified Alien
U.S. Citizen:

Submit ONE of the following ORIGINAL documents to the Financial Aid Office:
- Birth Certificate
- U.S. Passport or Passport card
U.S. Naturalized Citizen

Submit ONE of the following ORIGINAL documents to the Financial Aid office:
- U.S. Passport or Passport card
- Certificate of Birth Abroad (FS-240, FS-545, or DS-1350)
- Certificate of Citizenship (N560, N561)
- Certificate of Naturalization (N550, N570)
U.S. Permanent Resident (I-94 designated as "Refugee"; "Asylum Granted". "Parolee" or "Cuban-Haitian Entrant"; or "Conditional Entrant")

BRING ONE of the follwoing ORIGINAL documents to the Financial Aid Office:
- Alien Registration Receipt/Resident Alien/Permanent
- Resident/Conditional Permanent Resident card (I-1551, I-94, I-94A)
- Foreign passport with I-551 endorsement
- Arrival/Departure Record I-94 with I-551 endorsements
Other eligible non-citizen

BRING ONE of the following ORIGINAL documents to the Financial Aid Office:
- Arrival/Departure Record (I-94, I-94A or I571 with proper endorsements)
After we receive your documents, we will send them to the Department of Homeland Security (DHS) for verification of your status. It can take up to 8 weeks for DHS to respond.
Victim of Human Trafficking or Battered Immigrant-Qualified Alien

SUBMIT ONE of the following ORIGINAL documents to the Financial Aid Office:
- Eligibility letter from Health and Human Services (HHS) or;
- T-visa Form I-797, Notice of Action Form from the US Citizenship and Immigration Services (USCIS), with a vaild expiration date verifying financial aid eligibility.
I HEREBY CERTIFY THAT ALL INFORMATION REPORTED ON THIS FORM AND ANY ATTACHMENTS HERETO ARE TRUE, COMPLETE AND ACCURATE. FALSE STATEMENTS OR MISREPRESENTATION WILL BE CAUSE FOR DENIAL, REDUCTION, WITHDRAWL AND/OR REPAYMENT OF FINANCIAL AID.
Please upload supporting documentation:

Example: Passport, letter, alien registration card, birth certificate, etc.
Cancelof
Student Signature

Clear
Date

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Date
Should be Empty:

2025-26 Citizenship Status Confirmation Form