DIRECTIONS
CITIZENSHIP STATUS
ACADEMIC YEAR 2016-2017
Send Completed Form To:
We have received the results of your 2016-2017 Free Application for Federal Student Aid
(FAFSA). Your application is on hold because we have incomplete citizenship status information.
Please complete and sign this form certifying that the information is true. Processing of your
financial aid application will continue when this form is returned with the appropriate
documentation to the Office of Enrollment Services (ES) at the address above.
University of Rhode Island
Enrollment Services Green Hall
6 Rhody Ram Way
Kingston, RI 02881 USA
Phone: (401) 874-9500
Fax: (401) 874-2002
To fill in the form, select the field and type. Print the completed form to add the required Website: web.uri.edu/enrollment
signature(s).
Student information
Name (last, first, middle initial)
Birth date
Address (street or P.O. box number, city, state, ZIP code)
Are you a United States citizen?
Student ID number
Telephone number (home)
yes
no

If you are a United States citizen, attach a signed copy of one of the following documents:

your United States birth certificate

your Certificate of Citizenship

your Certificate of Naturalization

your United States passport

If you are not a United States citizen, attach copies of both sides of your U.S. Citizenship and Immigration Services (USCIS)
document to this form.
THE FOLLOWING CHART shows USCIS documents acceptable for financial aid purposes. The endorsements listed correspond to the alphabetical
letter given in the chart. If you do not have these documents, bring a copy of your U. S. passport to the Office of Enrollment Services at the address
listed above.
INS status
U.S. permanent resident
Native American born in
Canada
Refugee status granted
Asylum status granted
Parolee
Form with endorsement needed
I-151 form, I-551 “green card,” I-94 form, or passport with endorsement A or B
Proof that the applicant was born in Canada and is at least 50 percent Native
American blood
I-94 form with endorsement C or D
I-94 form with endorsement E
I-94 form with endorsement F
Endorsements:
A. “Processed for 1-551. Temporary Evidence of Lawful Admission for Permanent Residence. Valid until (date). Employment
Authorized.”
B. “Temporary Form 1-551. Admission for permanent residence at (port) on (date) verified. (office of issuance) (date) (signature of
issuing officer) (title).”
C. “Admitted as a Refugee Pursuant to Section 207 of the Act. If you depart the United States, you will need prior permission to
return. Employment Authorized.”
D. “Status changed to refugee pursuant to Section 207(c) (2) of the Immigration Nationality Act, on (date). Employment Authorized.”
E. “Asylum status granted pursuant to Section 208. INS Valid to (date). Employment Authorized.’’
F. “(Applicant) ‘paroled’ for an ‘indefinite’ period for ‘humanitarian’ reasons.”
Certification
You must sign this form certifying that the information you provided is true. Misrepresentation of facts in connection with this form
may be sufficient cause, in and of itself, for cancellation or repayment of financial aid, whenever discovered.
Signature
Date signed
The University of Rhode Island is an equal opportunity employer committed to the principles of affirmative action
Rev. 02/2016