Fillable 2019-2020 DECLINE OF AID FSFA71 S I All (Sacramento City College)

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2019-2020 DECLINE OF AID FSFA71 S I All (Sacramento City College)

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2019-2020
DECLINE OF AID
FSFA71
S
TUDENT
I
NFORMATION
___________________________________________________________ ______________________________
___
Last Name First Name M.I.
Student ID#
1. I am requesting to decline financial aid for the following semester(s):
All Semesters Fall 2019 only Spring 2020 only Summer 2020 only
2. Fund Type(s) declining:
Decline all financial aid funds*
OR
Decline selected fund(s)
Federal Work Study Pell Grant Cal Grant
FSEOG CHAFEE
Federal Direct Subsidized Loan Federal Direct Unsubsidized Loan
Other: ____________________
3. Reason/comments for request:
______________________________________________________________________________________________
______________________________________________________________________________________________
By signing this form, I understand if I received financial aid at this college for the semester(s) I selected above, I must
repay all financial aid funds back to the college before this form can be processed.
* In addition, I understand that if I choose to decline all my financial aid funds for any semester and I want to re-open my
file, I must complete a Reinstatement of Aid form and submit to the Financial Aid Office for review.
Student Signature: Date:
For Office Use Only
Comments:
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Staff Signature: Date:
Print Staff Name: __________________________________________________
RETURN TO FINANCIAL AID OFFICE:
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2019-2020 DECLINE OF AID FSFA71 S I All (Sacramento City College)

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Completed 5 September 2020

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