2019-2020
EARLY REFERRAL of OVERPAYMENT
FSFA81
S
TUDENT
I
NFORMATION
___________________________________________________________ ______________________________
Last Name First Name M.I.
Student ID#
I cannot repay my federal grant overpayment in full at Sacramento City College within 45 days. I will
make a payment plan of the federal portion of my overpayment with the U.S. Department of Education.
By signing my name below, I give permission for the Sacramento City College Financial Aid Office to
forward my information to the U.S. Department of Education before the 45 day deadline.
Once my overpayment has been forwarded, I MUST repay the U.S. Department of Education and cannot
repay the federal share of my overpayment at Sacramento City College. I will be notified once my
overpayment has been forwarded to the Department of Education.
RETURN TO FINANCIAL AID OFFICE:
CERTIFICATION AND SIGNATURE
By signing this form I certify that all the information
reported is complete and correct.
Student: Date:
WARNING: If you purposely give false or
misleading
information on this worksheet,
you may be fined,
sentenced to jail, or both.
By submitting this early referral request, you may no longer make a payment to Sacramento City
College for the federal portion of your overpayment. Additionally, you are no longer eligible to
receive federal financial aid. It will take the U.S. Department of Education approximately 6-8 weeks
to update your account information.
