Social Security Number Certification Form For Parents printable pdf download

Social Security Number Certification Form For Parents

2015-16 Social Security Number Certification Form for Parents

Student Name: _______________________________

Cougar ID: ___________________

Form must be completed in black ink only.

List Cougar ID# on all attachments.

Each parent in the household providing information on the 2015-2016 FAFSA must provide

readable copies of each parent’s Birth Certificate and Social Security Card. Indicate which

forms are attached:

Parent 1 Information

Current Name (Please print)___________________________________________________________

First name

Middle Initial

Last Name

Date of Birth (MMDDYYYY) ___________________________________________________

Social Security Number ______________________________________________________

Parent 1 – Birth Certificate attached (required)

_____ Yes

Parent 1 – Social Security Card attached (required)

_____ Yes

NOTE: If name on Social Security Card does NOT match current name reported above, you must obtain

a new Social Security Card and attach to this form.

Parent 2 Information

Current Name (Please print) ___________________________________________________________

First name

Middle Initial

Last Name

Date of Birth (MMDDYYYY) _____________________________________________________

Social Security Number ________________________________________________________

Parent 2 – Birth Certificate attached (required)

_____ Yes

Parent 2 – Social Security Card attached (required)

_____ Yes

NOTE: If name on Social Security Card does NOT match current name reported above, you must obtain

a new Social Security Card and attach to this form.

By signing below I certify that all of the information reported is complete and correct.

________________________________________ ________________________

Parent Signature (Required)

Date

FA15PSN

Social Security Number Certification Form For Parents