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200109053
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Last modified
10/14/2011 9:29:01 AM
Creation date
10/20/2005 10:07:15 PM
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DEEDS
Inst Number
200109053
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200109053 <br />EXHIBIT B -16 <br />STUDENT VERIFICATION <br />THIS SECTION TO BE COMPLETED BY MANAGEMENT AND EXECUTED BY STUDENT <br />This Student Verification is being delivered in connection with the undersigned's eligibility for residency in the following apartment: <br />Project Name: <br />Building Address: <br />Unit Number, if assigned: <br />I hereby grant disclosure of the information requested below from <br />Signature <br />Name of Educational Institution <br />Date <br />Printed Name Student ID# <br />Return Form to: <br />THIS SECTION TO BE COMPLETED BY EDUCATIONAL INSTITUTION <br />The above -named individual has applied for residency or is currently residing in housing that requires verification of student status. <br />Please provide the information requested below: <br />Is the above -named individual a student at this educational institution? YES NO <br />If so, part -time or full -time? PART -TIME FULL -TIME <br />If full -time, the date the student enrolled as such: <br />Expected date of graduation: <br />I hereby certify that the information supplied in this section is true and complete to the best of my knowledge. <br />Signature: Date: <br />Print your name: Tel. #: <br />Title: <br />Educational Institution: <br />NOTE: Section 1001 of Title 18 of the U.S. Code makes it a criminal offense to make willful false statements or misrepresentations to any Department or <br />Agency of the United States as to any matter within its jurisdiction. <br />01- 351904.01 <br />B -23 <br />
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