Arizona State University Citizenship/Status Verification Form 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/ Certificate of Indian Blood (CIB) (requires a legible copy of your photo ID) Signed U.S. Social Security Card (requires a legible copy of your photo ID) Signed Certificate of U.S. Citizenship (Form N-560 or N-561) OR Signed 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) - (requires a legible copy of your photo ID) Signed U.S. Passport (current or expired), unless stamped non-citizen national OR Signed 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 legible 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) International Student: F1 – US Visa and I-20 J1 – US Visa and DS-2019 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 Accepted formats for submission are as follows: via email at registrar@asu.edu; via mail (see address information below) or in person at any of the campuses listed below. Downtown Phoenix campus Enrollment Services University Center Bldg - 166 411 N. Central Phoenix, AZ 85004 602-496-4372 Polytechnic campus Enrollment Services Student Affairs Complex - Bldg 350 7001 E. Williams Rd. Mesa, AZ 85212 480-727-3278 Tempe campus University Registrar's Office Student Services Building PO Box 870312 Tempe, AZ 85287 480-965-3124 West campus Enrollment Services University Services Building - 120 PO Box 37100 Phoenix, AZ 85069 602-543-8203 All of the information on this form is confidential and in compliance with the Family Education Rights and Privacy Act of 1974. rev 3/05/10 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 emailed, mailed, faxed, 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 License/Identification Card (issued October 1, 1996 or later) Current/valid Drivers License, Instructor Permit or Non-Operator Identification card from a U.S. state issued since 2000 or later States for which licenses are not acceptable as a primary source of verification are Hawaii, Maryland, Massachusetts, Michigan, New Mexico, North Carolina, Oregon, Texas, Utah, and Washington, as these states do not verify lawful presence in the U.S. 5. Unexpired Foreign passport with U.S. Visa, with I-551 stamp or attached 6. U.S. Military DD-214 documentation** ID Card for active duty, reserve or retired 7. Permanent Resident Card with photograph (Form I-151) issued since 1997 or later Resident Alien Card (Form I-551) issued before 1997 Alien Registration Receipt Card with photograph (Form I-551) issued prior to June 1978 8. Refugee Travel Document** (Form I-571) Issued since 2003 Bureau of Indian Affairs/Tribal identification card 2. 3. U.S. Social Security card** Issued by the Social Security Administration Certificate of U.S. Citizenship (Form N-560 or N-561) issued by USCIS through a federal or state court or through administrative naturalization after December 1990 Form I-94** * arrival/departure record with endorsement expiration date must not have passed stamp showing admission under section 207 (refugees) or section 208 (asylee) of the Immigration Nationality Act Certificate of Naturalization (Form N-550 or N-570) issued by USCIS 4. Birth Certificate** showing birth in the United States, which includes 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, unless the person was born to foreign diplomats residing in the US. Affidavit of birth** Tribal Certificate of Indian Blood** 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 U.S. Passport (current or expired) - unless stamped non-citizen national 9. Voter’s Registration Card** U.S. Armed Forces Driver’s License U.S. Military card or draft record Military dependent’s ID card** 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 legible copy of a photo id in order to be eligible for verification.