AUTHORIZATION TO RELEASE FINANCIAL INFORMATION
The Family Educational Rights and Privacy Act (FERPA) of 1974 is designed to protect the privacy of a student's
educational records. These confidential records include financial aid, scholarship and billing/account information, and
will not be released without written consent from the student. By signing this form, the student authorizes
University personnel to release confidential information to designated person(s).
Student Name: _____________________________________ Last 4-digits of MSU Student ID # _____________________
I authorize the Student Account’s Office, Residence Life, and/or the Office of Financial Aid Services of Montana State
University to discuss confidential account information for the purposes of understanding and meeting University
related financial obligations with the person(s) listed on this form.
I understand that the person(s) listed on this form will have access via telephone, in person, or by U.S. and
electronic mail to information that may include the following:
•
My financial aid and scholarship records, including processing and eligibility status as well as award types and
amounts. This information will not include specific parental income or asset information.
•
My student account and statements, including credits and debits posted to that account and any refund
amounts I may have received.
•
My housing and dining account, which may include amounts owed as well as amounts paid.
•
Any other unpaid bills that are owed to the University.
This authorization form does not allow the University to release specific academic information.
Name(s) of people to release information to: (Please print)
Authorization Password
Please limit the password to one printed word. The authorized person(s) will be expected to know this password.
This authorization will remain in effect until revoked in writing by the student.
CHECK HERE IF THIS IS UPDATED INFORMATION
Student Signature: Date:
Return the completed form to: Student Accounts
102 Montana Hall
PO Box 172640
Bozeman, MT 59717-2640
E-mail: studentaccounts@montana.edu
OR Office of Financial Aid Services
183 Strand Union Building
PO Box 174160
Bozeman, MT 59717-4160
E-mail: finaid@montana.edu
FERPA_06 16
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