2013-2014 SNAP (Food Stamp) Confirmation

Federal Student Aid Programs

Cayuga Community College

Financial Aid Office * 197 Franklin Street, Auburn, NY  13021 * FAX 315-252-2185

                        Auburn Office – 315-255-1743 ext. 2470  *  Fulton Office 315-592-4143 ext. 3004

You indicated on your FAFSA that you or your parents received Food Stamps in 2010

or 2011.  Please indicate below if this information is correct and provide the required documentation.

_______     I received Food Stamps in 2010 or 2011.

Please attach a copy of your current Common Benefit Identification Card (CIBC)

_______     I did not receive food stamps in 2010 or 2011.

Please contact the Financial Aid Office regarding corrections to your FAFSA.

I certify that the above information is true and complete.  I understand that failure to accurately report information may jeopardize my eligibility for Financial Aid.  I also understand that the U.S. Secretary of Education has the authority to verify information reported on the FAFSA with the Internal Revenue Service and other federal agencies.  I understand that giving false or misleading information may lead to fines up to $20,000, prison, or both.

Student Name_________________________________________________________________________

Student Social Security #_____________________________         C-Number______________________

Student Signature________________________________________________       Date_______________

Dependent Students

Parent Signature______________________________________________              Date_______________

Return this form to the Financial Aid Office at Cayuga Community College