Fillable Release-of-Authorization-Form Release of Authorization Form

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Release-of-Authorization-Form Release of Authorization Form

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The Release-of-Authorization-Form Release of Authorization Form form is 1 page long and contains:

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  • 10 other fields

Country of origin: US
File type: PDF

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Release of Authorization Form
Name: Account Number:
Address:
City, State, ZIP:
Phone:
Alternative Phone:
Email Address:
Thank you for your recent request to release your student loan account information to a third party. In order for Nelnet to
release account information, we must receive your written permission to do so.
Please complete the information on this page and upload it by logging in to Nelnet.com and selecting Documents. Then
choose Upload Documents and Forms. Or send this page to Nelnet via email (SubmitMyForms@Nelnet.net), or mail to:
Nelnet
Attn: Enrollment Processing
P.O. Box 82565
Lincoln, NE 68501-2565
Release of Authorization
I authorize Nelnet to release any information related to my student loan account to:
Individual or agency name (please print)
I understand that I may, at any time, withdraw this directive as long as I do so in writing.
I certify that I am the subscriber to the provided cellular or other wireless number and I authorize Nelnet and its
representatives and agents to contact me regarding servicing or repaying my loan(s) at any current and future
numbers that I provide for my cellular telephone or other wireless device using automatic dialing systems, articial or
pre-recorded messages, and/or SMS text messages, even if I will be charged by my service provider(s) for receiving
such communications.
Borrower signature: Date:
fb.com/Nelnet | @Nelnet P.O.Box 82561 | Lincoln, NE 68501 | p 888.486.4722 | Help@Nelnet.net | Nelnet.com
*If you do not have your account number, please provide your
Social Security number:
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Release-of-Authorization-Form Release of Authorization Form

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Completed 3 July 2020

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