Fillable Form B: Current students holding a Student Visa (University of Southern Queensland)

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Form B: Current students holding a Student Visa (University of Southern Queensland)

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The Form B: Current students holding a Student Visa (University of Southern Queensland) form is 2 pages long and contains:

  • 1 signature
  • 8 check-boxes
  • 51 other fields

Country of origin: AUSTRALIA
File type: PDF

Australia forms for University of Southern Queensland

BROWSE UNIVERSITY OF SOUTHERN QUEENSLAND FORMS

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TT (INTERNATIONAL BANK TRANSFER): Only use if funds were paid by international wire/international bank draft.
Bank Street
Address
Account Holder
Name
Account
Holder's
Overseas
Street Address
CNAPS Code
SORT Code
SWIFT / BIC
Code
Account
Number
Bank Name
Branch Name
Malaysian National ID /
Passport Number
Country
City
State
Preferred
Currency
IFSC Code
IBAN Number
International Student Refund Request
Other: SWIFT
Routing /
Transit Code
AUD
Last
Name
MICR Code
Application
Number
Refund Amount
Excess Funds
Other
(Please specify)
Street
Please supply applicable details for home country (Refer to Requirements by Country guide below)
Please complete ONE refund method below (e.g. TT, EFT, Credit Card)
* If fees were paid by credit card, refunds MUST be returned to the originating credit card.
*Fees paid by international bank transfer refunds will be returned to the student's home country as per USQ's Refund Policy.
For more information please refer to the USQ website for the Refund of Student Fees Policy and Procedure.
UK: SWIFT, IBAN & SORT
Malaysia: SWIFT & National ID
China: SWIFT & CNAPS
India: IFSC, SWIFT & MICR
USA: SWIFT & Routing
Requirements by
Country:
Country
City
State
Street
Form B
Current students holding a Student Visa
First Name
Date of Birth
REASON FOR REFUND: Please provide detailed reasoning to support your request.
Email Address
Please ensure that your student account is in credit and that you are eligible for a refund when submitting this form.
Continuing students with a credit balance are encouraged to offset this amount against their fees in the next semester.
Please return both pages of your form to: usq.support@usq.edu.au
Student
Number
Date
Note: Signature not required if emailing from
registered email account.
Approved WWP
Signature
Financial Services
A hard copy of this document is uncontrolled and may not be the current version.
The latest controlled version can be found on the Financial Services Forms page.
Version 4.0 June 2020
Page 1 of 2
Date of Birth
Email Address
Dropped Course/s
Approved Reduced Study Load
CREDIT CARD: Please select from the following options.
I paid my fees online through my Student Centre
The refund will be credited back against the originating credit card - you are not required to provide any further details.
I paid my fees in-person or over the phone
The refund will be credited back against the originating credit card - USQ Financial Services staff will contact you to obtain
full credit card details.
PRIVACY COLLECTION STATEMENT:
Approved
AUD
AUD
AUD
Accounts Payable to Process: Electronic Funds Transfer Telegraphic Transfer
International Student Refund Request
Form B
Continued
USQ collects personal information to assist the University in providing tertiary education and related ancillary services and to be able to contact you
regarding enrolment, assessment and associated USQ services. The information may be made available to Commonwealth and State agencies and the
Tuition Protection Service Director and Secretary pursuant to obligations under the Education Services for Overseas Student Act 2000 and National
Code or other legislative requirements. Personal information will not be disclosed to third parties other than a USQ approved agent, partner or any
organisation who provides sponsorship to you for your studies, without your consent unless required by law.
EFT (AUSTRALIAN BANK ACCOUNT): Only use if fees were paid by cash, cheque, direct transfer, BPAY or Australia Post.
Account Holder
Name
Signature - Director, Student and Academic Support
Name (Print or Stamp)
Date
Bank Name
Refund request approved in accordance with the Refund of Student Fees Policy and Procedure
Refund
Amount
Refund
Amount
Refund
Amount
Refund
Amount
Request ID
QI / Receipt
Number
QI / Receipt
Number
QI / Receipt
Number
STUDENT ADMINISTRATION USE ONLY:
Accounts Receivable to Process:
BSB
Financial Services
A hard copy of this document is uncontrolled and may not be the current version.
The latest controlled version can be found on the Financial Services Forms page.
Version 4.0 June 2020
Page 2 of 2
Request
ID
SF Processed
FINANCE USE ONLY:
SF Approved
Financial Delegate Initial & Date
Accounts Receivable Initial & Date
Accounts Payable Initial & Date
Voucher Number
PS Processed
SF Processed
SR#
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Form B: Current students holding a Student Visa (University of Southern Queensland)

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Completed 4 February 2021

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