International Student Deposit Refund Request
1.) Complete this form.
2.) Submit this form to the International Student and Scholar Services office using one of the following methods:
a. In person to:
International Student and Scholar Services, Student Service Center, 11139 Anderson St., Loma Linda, CA 92350
b. Email to:
c. Fax to: (909)558-7949.
3.) International Student and Scholar Services will verify eligibility and forward a copy of your form to the Student Finance
Office for processing, as noted below.
___________________________________________________ ______________________________________ ______________________________________
Last Name First Name LLU Student ID
__________________________________ ________________________________________ _____________________________
Email address Program Program Start & End dates
Please select one of the following:
1.) Incoming Student – Did not obtain F-1 or J-1 Student visa:
How was your deposit paid: check (demand draft) credit card (returned wire transfer/ACH
to original card, only)
Name of refund recipient: _____________________________________________________________________________
Refund recipient’s mailing address:
City State/Province Postal Code Country
NOTE: for this option #1, refunds may take 2 to 7 business days for the accounting process, depending on the type of refund.
Please allow up to 30 additional days for mailing through regular postal handling.
2.) Current Student – date completing program or date transferring out to a new school: ____________________
How was your deposit paid: check (demand draft) credit card wire transfer/ACH
3.) Current Student – changed status to a U.S. Permanent Resident, U.S. Citizen, or fully sponsored for tuition plus fees:
How was your deposit paid: check (demand draft) credit card (may be wire transfer/ACH
returned to original card)
NOTE: for options #2 and #3, your deposit is moved from LLU’s deposit account to your student account. If there is a credit
balance, you (the student) may request a refund of your credit balance by logging onto
www.llu.edu/ssweb, select the Student
Finance menu and “Request Account Withdrawal” or you may personally visit the Student Finance Office in the Student Service
OISS Approval: _______________________________________________ Date: _______________