Your Free Application for Federal Student Aid (FAFSA) has been selected for the federal verification process. You must complete and submit this form to Student Finance. Student Finance will compare information from your FAFSA with information on this form and on other documentation you may be required to submit. Student Finance may make electronic corrections to your application as a result of the verification process, which may result in changes to your financial aid awards. The original copy of this completed form, with your original signature, must be provided to DeVry University by either presenting this documentation in person at a DeVry University location or by mailing the documentation to DeVry University Student Finance Operations. If submitting in person – Please schedule an appointment with a Student Finance staff member at your local campus. Section B of this form must be signed in the presence of, and presented to, an authorized DeVry University Student Finance staff member. Your identity will need to be verified at that time by presenting a valid government-issued photo identification, such as, but not limited to, a driver’s license, other state-issued identification, or passport. If submitting by mail – Section C of this form must be signed in the presence of, and notarized by, a notary public. Your identity will need to be verified at that time by presenting a valid government-issued photo identification, such as, but not limited to, a driver’s license, other state-issued identification, or passport. A copy of the piece of identification presented to the notary public to complete Section C will need to be placed in Section D of this form. Once completed, please mail the form to: DeVry University Student Finance
2349 West Lake Street, Suite 100
Addison, IL 60101 A. Student Information Student Name | Student ID Number | Gaither St. | | Address | City | State | Zip | Phone Number | Email Address | | | B. Statement of Educational Purpose (To Be Signed at DeVry University) | | | Complete this section only in the presence of an authorized DeVry University employee. I certify that I am the individual signing this

(Print Student’s Name)
Statement of Educational Purpose and that the federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending DeVry University for 2013-2014.

Student Signature Student ID Number Date

| | Student Name | Student ID Number | -------------------------------------------------
C. Statement of Educational Purpose (To Be Signed With Notary) Complete this section only while in the presence of a notary public. I certify that I am the individual signing this

(Print Student’s Name)
Statement of Educational Purpose and that the federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending DeVry University for 2013-2014. Student Signature | Student ID Number | Date | | Notary’s Certificate of Acknowledgement | | State of City/County of

On , before me, ,

(Date) (Notary’s name) personally appeared, , and proved to me on basis of

(Printed name of signer) satisfactory evidence of identification

(Type of government-issued photo ID provided) to be the above-named person who signed the foregoing instrument. WITNESS my hand and official seal (seal) | | | (Notary signature) | My commission expires on

(Date)

| Student Name | Student ID Number | | | D. Verification of Identity | | In the space below, place and copy your valid government-issued photo identification. If presenting this document in person to a DeVry University employee, the original piece of identification must be current (unexpired) as of the date it is presented. If signing this document in the presence of a notary public, the original piece of identification must be current (unexpired) as of the date it is presented to the notary public as indicated in Section C. -------------------------------------------------
Place and Copy Photo ID Here

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This Section for Use by Authorized DeVry University Employees Only I hereby certify this documentation was received and completed in my presence on the date noted below.

Employee Name (Printed) Employee Signature Date