Student Signature Date
Student ID Number
Authorization for the Release of Financial Aid Information
By completing this form, you authorize the Financial Aid Oce at the University of Pittsburgh to discuss
information regarding all aspects of your nancial aid, except for information pertaining to your
academic progress, to the individuals whom you list below, including your parents, your spouse, or outside
organizations. Please note that this is a precautionary measure taken to protect your privacy.
This release will remain in eect until you revoke privileges in writing.
I ________________________________________, hereby authorize the University of Pittsburgh’s Financial Aid
Oce to provide information regarding my nancial aid to the person, agency, or program listed below.
Name Relationship Date of Birth
FORM ID: F20RIF REV:10.26.18
(Print Name)
Financial Aid