SSER17
Panther ID Number
P.O. Box 4040  Atlanta  GA 30302-4040
Atlanta Campus: 404-413-2600
PC Campuses: 678-891-3535
 Fax: 678-891-3427http://sfs.gsu.edu
Selective Service Verification
Student’s Last Name
First
MI
A review of your Free Application for Federal Student Aid (FAFSA) indicates that the Selective Service reported that you have not
registered with them. In order to determine your eligibility for Federal Student Aid, all U.S. male citizens are required to register
with the Selective Service. If you are a male, and are 18 through 25 years of age, and have not registered with Selective Service, you
can do so by completing a Selective Service registration form at your local post office or register online at www.sss.gov. A complete
listing of who must register may be obtained at www.sss.gov.
Section I
Please select the response that best applies below and submit the required documentation,
 I am a male
Documentation
 I am between the ages of 18 and 25 and have
registered with Selective Service.
 I was born before 1960 and was not required
to register.
 I entered the U.S. after age 26.
A copy of your signed selective service registration card
OR
Official letter of verification from www.sss.gov
None
Proof of citizenship with your date of entry into U.S.
OR
Official Letter of Verification stating that you were not
required to register from www.sss.gov
What was your Date of Entry?
Month
 I am older than age 26 and have not registered.
Day
Year
Complete Section II of form.
 I am between the ages of 18 and 25 and I will
not register for Selective Service.

I am a female and am not required to register.
I self-certify that I am legally a female.
CERTIFICATION STATEMENT:
“I certify that this information is true and correct to the best of my knowledge. Additionally, I understand that I
am responsible for returning all student financial aid monies received due to inaccurate, false or misleading
information provided on this form and/or any other documents submitted.”
Student’s Signature
Date
(Required)
Print (Don't forget to sign form!)
Selective Service Verification
Page 1 of 2
rev. 03.01.2016
SSER17
Panther ID Number
SECTION II
You have indicated that you did not register prior to age 26 or will not register for Selective Service. Please provide and
complete each of the following items:
1. Official Letter of Verification from Selective Service at www.sss.gov.
2. Complete Part B below.
3. Provide documentation to support the statement provided in Part B.
a. If you were not a U.S. citizen and resided in the U.S. from ages 18 to 26, please provide a copy of your
citizenship documentation for the ages 18 to 26 and provide the date you entered the U.S
What is the date that your entered the U.S.?
Month
Day
Year
Part B.
Please provide an explanation as why you did not or will not register with Selective Service and the
statement must be notarized. Attach additional sheet(s) as needed.
Georgia State University’s Financial Aid Office will review all documentation submitted and will make a determination of your financial
aid eligibility. Please be advised that students that were required to register with Selective Service, but did not are subject for review
and approval by Georgia State University’s Financial Aid Office. If you were previously approved at a prior institution, it does not
guarantee approval at Georgia State University.
NOTARIZATION:
I certify the above statement as true and accurate with my
signature and notarization by notary public. Additionally, I
understand that I am responsible for returning all student
financial aid monies received due to inaccurate, false or
misleading information provided on this form.
Student’s Signature
Selective Service Verification
Date
Page 2 of 2
Print (Don't forget to sign form!)
rev. 03.01.2016