2023-2024 Form 44 V4-Custom Verification

2023-2024 Form 44 V4-Custom Verification
Campus Location*
Your Free Application for Federal Student Aid (FAFSA) was selected for review in a process called "verification". In this process, the Financial Aid Office compares the information provided on this form to the information you provided on your FAFSA. If there are differences, your FAFSA data may be corrected.
Student Information
Name*

First NameLast Name
Student ID*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Dependency Status
Please Select Your Dependency Status:
If you are a dependent student, your parent is required to sign this worksheet. Please enter their contact information below. They will receive an email inviting them to complete their portion of this form and add their electronic signature. Please remind them to check their Junk email folder if the invitation does not arrive in their Inbox. This form cannot be processed without their signature.
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Identity/Statement of Educational Purpose
The student must appear in person at Heritage University 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 with the date it was received and the name of the official at the institution authorized to collect the student's ID.

If you cannot appear in person to submit this worksheet, you must provide a copy of your government issued ID and have the back side of this worksheet notarized by a public notary.

Statement of Educational Purpose
I certify that I, First Name Last Name , am the individual signing this Statement of Educational Purpose and that the Federal Student Aid I may receive will only be for educational purposes and to used to pay for the cost of attending Heritage University for 2023-2024.
Signature

Clear
Date

MonthDayYear
Date
Certification and Signature

Each person signing this worksheet below certifies that all of the information is reported on it is complete and correct.
Student Signature*

Clear
Date

MonthDayYear
Date
Parent Signature

Clear
Date

MonthDayYear
Date
HAVE QUESTIONS ABOUT YOUR FINANCIAL AID?

Financial Aid Office Contact Information

Address: ATTN: Financial Aid 3240 Fort Rd., Toppenish, WA 98948 | Phone: (509) 865-8502 | Email: financial_aid@heritage.edu
Should be Empty:

2023-2024 Form 44 V4-Custom Verification

Student Information

Dependency Status

Identity/Statement of Educational Purpose

Certification and Signature