8/13/2019 Authorization 001

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B R I A R C L I F F E ,

Authorization  for T i t l e  I V Financial  A i d   Funds

Student/Parent Authorizations

Under federal guidelines, Title  IV financial aid funds  w i l l  be credited to the student's account, without separate authorization, for tu i t ion, requirfees, and room and board  ( i f  contracted  w i t h   the school). I authorize Briarcliffe College - Online to take the f o l low ing  actions regarding T it le  

financial  aid   funds  draw a line through any statements below that you do not wish to author ize):

1. T it le   IV  funds may be used for other current educationally related charges applied to my student account at the school

including, books, supplies, and any other direct or indirect charges.

2.  Credit balances that may result  f rom   the crediting of T it le   I V   financial aid funds to my student account may be retained and

applied to allowable future charges incurred to my student account. In authorizing retention of any such credit balance, i t is

understood that I w i l l receive no interest on the funds that are retained.

3. Credit balances that may result f rom   the crediting of T it le  IV financial  aid funds to my student account may be applied to prior

award year charges of no  more than $ 200 that were charged to my account and not previously paid, as long as payment of the

prior award year charges w i l l not prevent me f rom   paying current educational expenses.

4.  If, upon my leaving school through graduation or withdrawal, a credit balance exists on my student account after  al l   Title  IV

refunds and  tuition  adjustments have been made, the credit balance may be applied to my Federal Stafford Loan and/or my

PLUS Loan to reduce my outstanding loan balance.

voluntarily make the above authorizations and understand that I may modify or rescind the authorizations at any time through

written notification to the Financial A id   Office.  I understand that I w i l l be required to make cash payments for any charges for which I

do not authorize use of Title   IV   funds.

Student (borrower)

T o  be Signed by P A R E N T  B O R R OW E R if Federal  Parent-PLUS Loan

} « 2 C  Talcum j >Dirte  / Printed Name of Student Last 4 digits of SSN

Signature of Parent Date Printed Name of Parent Last 4 digits of SSN

Other Non-Title I V  Funds Authorization

In  addition to Title   I V  funds, I may receive non-Title I V  financial  aid funds, including but not  limited   to private scholarships, state

grants and/or private loans (referred to here as Other Funds ). I authorize Briarcliffe College - Online to take the f o l low ing   actions

regarding Other Funds  draw a line through any statements below that you do not wish to authorize):

1.  Other Funds may be used for all educationally related charges applied to my account,  including  tuition, fees, books, supplies,

and  an)»   other direct or indirect charges.

2.  Credit balances that may result  from   the crediting of Other Funds to my student account may be retained and applied to future

charges incurred and charged to my account. I understand that  1 w i l l receive no interest on the funds that are retained.

3. Credit balances that may result  f rom   the crediting of Other Funds to my student account may be applied to outstanding charges

from  prior years, as long as use of such credit balance  w i l l not prevent me f rom   paying current educational expenses.

4.  If, upon my leaving school through graduation or withdrawal, a credit balance exists on my account, such credit balance will

be used to reduce any loan indebtedness  of my   Other Funds by returning such credit balance to my lender.

voluntarily make the above authorizations and understand that I may modify or rescind the authorizations at any time through

written notification  to the school Financial Ai d   Office.  I understand that I w i l l  be required to make cash payments for any

charges for which I do not authorize use of Other Funds.

Signature of Student Date Printed Name of Student Last 4 digits of SSN

Effective:  6-30-03:4-28-04:11-12-07: PrY rAm t {200 2-18- 08: SSN to 4 d i g i t s   5-15-09

Add Parent to  PIUS  7-21-09: add   able t o  modify 2 I I I I : Add   other and  state  6-14-11  text  edits 6-30-1