2002 – 2003 FAFSA on the WEB Student Only Signature Page



Name: ___________________________________________Banner ID#:_________________________

Address_____________________________________________________________________________

Step One: Read the following

Students: By signing a signature page and submitting it to our office, you certify that you:

1. will use federal and/or state student financial aid only to pay the cost of attending an institution of higher education,

2. are not in default on a federal student loan or have made satisfactory arrangements to repay it,

3. do not owe money back on a federal student grant or have made satisfactory arrangements to repay it,

4. will notify your school if you default on a federal student loan, and

5. will not receive a Federal Pell Grant from more than one school for the same period of time.

Student and Parents: By signing a signature page and submitting it to our office, you agree to provide if asked:

1. information that will verify the accuracy of your completed form.

2. federal tax transcripts if you filed or are required to file.

You also certify that you understand that the Secretary of Education has the authority to verify information reported on your application with the Internal Revenue Service and other federal agencies. If you purposely give false or misleading information, you may be fined $20,000, sent to prison, or both.

Step Two: Sign Below

If parental information is provided on the FAFSA, at least one parent whose information is provided must sign.

Student Signature: ____________________________________ Date: _______________________

Parent Signature: _____________________________________ Date: _______________________

Preparer’s Certification: All of the information on this form is true and complete to the best of my knowledge.

Preparer’s Signature: ___________________________________ Date: _______________________

If you or your family paid a fee for someone to fill out this form or to advise you on how to fill it out, that person must sign.

Step Three: Submit this signature page to:

Manchester Community College

Financial Aid Office –MS #11

Great Path

P.O Box 1046

Manchester, CT 06045

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2014-2015 FAFSA on the Web Signature Page

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