1801 College Drive North, Devils Lake, ND 58301-1598
(701) 662-1600 • fax (701) 662-1570 • 1-800-443-1313 • TDD (701) 662-1572 • www.lrsc.edu
LATE FEE APPEAL FORM
In conjunction with the North Dakota State Board Policy 830.1, late fees shall be assessed to student’s
accounts if their account is 30 days past due. To appeal this late fee, students will need to fill out, sign and
return this form to the Business Office.
Last Name: __________________________ First Name: ____________________________ Student ID: ____________
Phone Number: __________________________ LRSC Email Address: ________________________________________
Term late fee was assessed (please check only one): Fall Spring Summer Year: __________
Have you had your late fee removed previously? Yes No
Please state the reason for appealing the late fee.
Late Scholarship Check Financial Aid Issues
Signing below certifies the information provided is true.
Each Semester’s due dates are published in the following manner:
• LRSC Website • LRSC Student Handbook • LRSC Student Registration Book
Section 1. Student Information
Section 2. Reason for Request
APPROVED ____________________ Date Removed ______________________ Initials ________
DENIED_______________________ Date ______________________________ Initials ________
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