Arizona State University



[pic] |Arizona State University

Citizenship/Status Verification Form

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State law now requires that a person who is not a citizen or legal resident of the United States or who is without lawful immigration status is not entitled to classification as an in-state student for tuition purposes pursuant to A.R.S. Section 15-1802. The responsibility of providing the proper residency documentation is placed upon the student. Any student who falsifies his/her residency may be subject to dismissal from the university.

|Student Name (Last, First, Middle | |

|Initial) | |

|ASU ID | |

|Phone Number | |

Please check which document you are submitting for verification:

| | |

| |Current/Valid Arizona Driver's License (issued October 1, 1996 or later) |

| | |

| | |

| |Current/Valid Driver's License (issued 2000 or later). States for which licenses are not acceptable as a primary source of verification are |

| |Hawaii, Massachusetts, Michigan, New Mexico, North Carolina, Oregon, Texas, Utah and Washington, as these states do not verify lawful presence in |

| |the U.S. |

| | |

| |Bureau of Indian Affairs/Tribal ID Card |

| | |

| | |

| |U.S. Social Security Card (requires a copy of your photo ID) |

| | |

| | |

| |Certificate of U.S. Citizenship (Form N-560 or N-561) OR Certificate of Naturalization (Form N-550 or N-570) |

| | |

| | |

| |U.S. Birth Certificate (includes certificates from Puerto Rico on or after January 13, 1941; Guam & the U.S. Virgin Islands on or after January |

| |17, 1917; American Samoa; Swains Island; or the Northern Mariana Islands) |

| | |

| |U.S. Passport (current or expired), unless stamped non-citizen national OR Unexpired Foreign Passport with U.S. Visa with I-551 |

| | |

| | |

| |U.S. Military ID (active duty, reserve or retired) OR DD-214 documentation (requires a copy of your photo ID) |

| | |

| | |

| |Permanent Resident Card (I-151 - issued since 1997 or later) |

| |Resident Alien Card (I-551 - issued before 1997) |

| |Alien Registration Card (I-551 - issued prior to June 1978) |

| | |

| |Other documentation: |

| | |

| |I certify that all the information supplied by me in this form is correct and complete, and I understand that any misrepresentation or |

| |falsification is sufficient cause for cancellation of enrollment and/or any credits earned and could result in other disciplinary action. |

______________________________________________________________________________________________________

Signature of Student Date

|Downtown Phoenix campus |Polytechnic campus |Tempe campus |West campus |

|Enrollment Services |Enrollment Services |University Registrar's Office |Enrollment Services |

|University Center Bldg - 166 |Student Affairs Complex - Bldg 350 |Student Services Building - |University Services Building - 120 |

|411 N. Central |7001 E. Williams Rd. |PO Box 870312 |PO Box 37100 |

|Phoenix, AZ 85004 |Mesa, AZ 85212 |Tempe, AZ 85287 |Phoenix, AZ 85069 |

|602-496-4372 602-496-0376 (fax) |480-727-3278 480-727-1008 (fax) |480-965-7302 480-727-6630 (fax) |602-543-8203 602-543-8312 (fax) |

All of the information on this form is confidential and in compliance with the Family Education Rights and Privacy Act of 1974. rev 6/15/07

Arizona State University

Acceptable Documents

The following is a list of acceptable documents to verify a student's citizenship, legal resident or other lawful presence status for purposes of determining eligibility for in-state tuition. Documents may be faxed, mailed, or submitted in person. Documentation that is submitted via fax or mail must be legible with no evidence of tampering. Final residency decisions for tuition purposes will be made in accordance with A.R.S. §15-1801 et. seq., as well as the policies and regulations of the Arizona Board of Regents and Arizona State University.

|The Most Common Ways to Provide Verification: |

|1. |Current/valid Arizona Motor Vehicle Department Driver |5. |U.S. Passport (current or expired) - unless stamped non-citizen |

| |License/Identification Card | |national |

| |(issued October 1, 1996 or later) | | |

| | | |Unexpired Foreign passport with U.S. Visa, with I-551 stamp or |

| |Current/valid Drivers License, Instructor Permit or Non-Operator | |attached |

| |Identification card from a U.S. state | |[pic] |

| |issued since 2000 or later |6. |U.S. Military |

|2. | | |DD-214 documentation** |

| |States for which licenses are not acceptable as a primary source of | |ID Card for active duty, reserve or retired |

|3. |verification are Hawaii, Maryland, Massachusetts, Michigan, New | |[pic] |

| |Mexico, North Carolina, Oregon, Texas, Utah, and Washington, as these|7. |Permanent Resident Card with photograph |

| |states do not verify lawful presence in the U.S. | |(Form I-151) |

| | | |issued since 1997 or later |

|4. |Bureau of Indian Affairs/Tribal identification card | |Resident Alien Card |

| |[pic] | |(Form I-551) |

| |U.S. Social Security card** | |issued before 1997 |

| |Issued by the Social Security Administration[pic] | |Alien Registration Receipt Card with photograph |

| | | |(Form I-551) |

| |Certificate of U.S. Citizenship | |issued prior to June 1978 |

| |(Form N-560 or N-561) | |[pic] |

| |issued by USCIS through a federal or state court or through |8. |Refugee Travel Document** |

| |administrative naturalization after December 1990 | |(Form I-571) |

| | | |Issued since 2003 |

| |Certificate of Naturalization | | |

| |(Form N-550 or N-570) | |Form I-94** |

| |issued by USCIS [pic] | |* arrival/departure record with endorsement |

| |Birth Certificate** showing birth in the United States, which | |expiration date must not have passed |

| |includes Puerto Rico (on or after January 13, 1941), Guam, the U.S. | |stamp showing admission under section 207 (refugees) or section 208 |

| |Virgin Islands (on or after January 17, 1917), American Samoa, Swains| |(asylee) of the Immigration Nationality Act |

| |Island, or the Northern Mariana Islands, unless the person was born | |[pic] |

| |to foreign diplomats residing in the US. | |Voter’s Registration Card** |

| | |9. |U.S. Armed Forces Driver’s License |

| |Affidavit of birth** | |U.S. Military card or draft record |

| |Tribal Certificate of Indian Blood** | |Military dependent’s ID card** |

| |Consular Report of Birth Abroad** | | |

| |(Form FS-240) | | |

| |Issued by State Department | | |

| |Certificate of Birth from Foreign Service Post** | | |

| |(Form FS-545) | | |

| |Issued by State Department | | |

| |Certification of Report of Birth** | | |

| |(Form DS-1350) | | |

| |Issued by State Department | | |

| | | |If you do not possess any of the documentation listed please contact |

| | | |the University Registrar’s Office at |

| | | |480-965-7302 for assistance. |

**indicates that this document must accompany a copy of a photo id in order to be eligible for verification.

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