Student Financial Aid Refund Direct Deposit Authorization Form
Authorize student financial aid refunds to be sent by direct deposit and provide the details needed to process the refund.
Student Information
Student's Full Legal Name
*
First Name
Middle Name
Last Name
Student ID or Campus Identifier
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Refund Deposit Details
Refund delivery method
*
Direct deposit to my designated bank account
Account holder name as it appears on the bank account
*
First Name
Middle Name
Last Name
Account type
*
Please Select
Checking
Savings
Bank name
*
Voided check or deposit confirmation document
Upload a File
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Authorization and Submission
Authorization acknowledgment
*
I authorize the deposit of my student financial aid refunds to the designated account
I do not authorize the deposit of my student financial aid refunds to the designated account
Electronic signature
*
Date signed
*
 -
Month
 -
Day
Year
Date
Submit
Submit
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