Texas Tech University | Student Financial Aid & Scholarships       www.financialaid.ttu.edu    Citizenship Affidavit

T 806.742.3681 email finaid.advisor@ttu.edu RETURN TO: Student Financial Aid Office PO Box 45011 Lubbock, TX 79409‐5011 

Student Financial Center | West Hall 301 

CitizenshipAffidavit

Ifyouarenotabletoprovideyourdocumentsinperson,pleasesubmitthisaffidavitalongwithyourdocumentation.

Student Name: R#:

This form is for the collection of DHS or other U.S. citizenship/nationality documents from students unable to present their documents in person.

I certify that I, ___________________________________, am the individual signing this statement, and I am providing a copy of my documents along with a copy of a valid government- issued photo identification card bearing my portrait (or likeness).

I certify that the attached documents and government issued photo identification are true, exact, and complete copies of the originals issued to me.

List of documents:

Name of valid photo ID Expiration date of valid photo ID

Issuing authority of valid ID

Example: Driver’s license 01/01/2020 State of Texas

Name of citizenship and/or immigration document(s)

Expiration date (if any) of citizenship and/or immigration document(s) 

By signing this form, you are certifying that all information on the form is correct and that, if asked, you will provide the requested Documents to verify the information.  If you purposely give false or misleading information on this form, it could result in being fined, sent to prison, or both. 

Student Signature: ___________________________ Date: ____________