University of Central Missouri
Office of Student Financial Services
P.O. Box 800
Warrensburg, MO 64093-5178
Phone 660-543-8266
FAX 660-543-8080
Web:
www.ucmo.edu/sfs
Request to Reduce or
Cancel a Work-Study
E
arnings Allotment
2018/2019
WSRC1
____________________________________________ 700____________________________
Student’s Name (please print) UCM ID Number
Please take the following action regarding the Federal Work-Study earnings allotment I was
offered:
Cancel my allotment for the following period (mark only one):
____ 2018 Fall Semester ____ 2018/2019 School Year
____ 2019 Spring Semester ____ 2019 Summer Session
My last day of work was (or will be) __________________________________________
Reason for cancellation: ____________________________________________________
________________________________________________________________________
Reduce my allotment for the following period from $ _____________ to $ ____________
____ 2018/2019 School Year ____ 2018 Fall Semester
____ 2019 Spring Semester ____ 2019 Summer Session
Reason for this reduction: __________________________________________________
________________________________________________________________________
I understand that the UCM Office of Student Financial Services is required to report changes in my
Federal Work-Study earnings allotment to any agency or organization external to UCM who is also
providing me financial assistance.
Student’s Signature Date ___________________
UCM USE ONLY
Total amount this student will have earned for the above period: $______________________
Total hours this student will have worked for the above period: ________________________
Supervisor’s Signature _______________________________ Date ___________________
Complete and submit this document to the UCM Office of Student Financial Services in person
(1100 Ward Edwards Bldg.) or by mail (University of Central Missouri, Student Financial Services,
P.O. Box 800, Warrensburg MO 64093-5178), or by fax (660-543-8080).
Reduce_WS-18.pdf NOV 3, 2017
