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Identity Verification Form

Please do not include private information in the text or images within the following fields (such as Social Security numbers, passwords, etc.). Fields marked with an * are required). If you need to contact the IT Helpdesk, you can review the Need Help? section on the IT Helpdesk web site.

We'll use this to send you updates or ask for additional information if necessary
Your given (first) name.
Your middle given name (if applicable).
Your surname (last).
Month, Day, Year (MM/DD/YYYY)
Example: A12345678 (found on the front of your campus ID Card).
Area Code & Number (###-###-####)

Select the option below next to the Photo ID Type Attached that will be attached to the form. Please do not include an ID that contains private information (such as a Social Security card). If the ID is not an OSU ID Card, please include one that contains your picture and name. The ID can either be faxed, a picture can be taken with a Smart Phone (example: iPhone, Android, etc.), using a scanner connected to a computer, etc.

Photo ID Type Attached
Take a photo of you holding the photo ID card with a device (such as a smart phone) to compare.
Reason For Verification

By submitting this form, I attest I am the above-named person and am authorizing Information Technology to assist me with attaining access for legitimate education or professional pursuits. A handwritten signature and printed name must be provided. Electronic signatures are not accepted.

An image of your handwritten signature and printed name (such as on a piece of paper taken with a smart phone or scanner).
Month, Day, Year (MM/DD/YYYY).
If you contacted the Helpdesk before completing the form, an e-mail from helpdesk@okstate.edu includes the number (example: L6UED4449210). Otherwise disregard.
Other information (if any) you want to include.