FINANCIAL AID OFFICE
THIRD PARTY RELEASE FORM
MSU Northern makes every effort to protect the privacy of your educational
records. HEA 483(a)(3)(E), requires that FAFSA data only be used for purposes of
the application, award, or administration of federal, state, or institutional aid, or aid
awarded by other entities as designated by ED. Per the FY 2018 Spending bill,
Universities may release FAFSA information to Scholarship providers and tribal
organizations only with written consent of the student. If you wish MSUN to
release information to a third party for either purpose listed above, please fill out
and sign this form.
I, _______________________________________, consent to the release of my
FAFSA information to the following scholarship provider or tribal organization.
Organization(s):
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
This is release is in effect from_____________,to________________.
(If not designated, release is in effect until graduation)
Signature Date
MSU Northern does not discriminate on the basis of race, color, national origin, age, sex, or disability.
MSU Northern
P.O. Box 7751
Havre, MT 59501
Tel: (406) 265-3787
Fax: (406) 265-3519
Toll Free: 1-800-662-6132
SSN#/ID#:_____________________________
