SANTA ANA COLLEGE FINANCIAL AID OFFICE
THIRD PARTY RELEASE FORM 2019-2020
Authorized Release Code: ______________
(Code will be assigned to the student when the student turns in this complete form in person, present a picture ID and sign in
the presence of Financial Aid staff)
Student Name Student Social Student ID
The Family Educational Rights and Privacy Act of 1974 (FERPA) was enacted to protect the privacy of educational
records, to establish the right of students to inspect and review their education records and to provide guidelines
for the correction of inaccurate or misleading statements.
FERPA prohibits agencies and educational institutions from releasing confidential information about a student
without the student's consent unless they are releasing that information to provide financial and award information
to federal, state and campus personnel who have a legitimate need to know this information. Records may be
released to a third party, including a parent or guardian, only after receiving student authorization.
If you wish to allow a third party access to your confidential financial or award information, please complete the
box below and turn this form in to us in person.
Program:
__ Pell Grant __ SEOG __ FWS __ Direct Sub Loan __ Direct Unsub Loan
__ Cal Grant __ BOGW __Other ______________________ __All programs
Third Party Release
I authorize the Santa Ana College Financial Aid Office to release my confidential financial and award information
to the following person who has my Authorized Release Code.
Name: ___________________________________________________________________________________
Last First Middle
Address: __________________________________________________________________________________
Street Number City State Zip
Relationship: ______________________________________________________________________________
I understand this consent release will expire on June 30
th
, 2020.
_________________________________________________________ ____________________
Student Signature (must present a picture ID and sign in the presence of FA staff) Date
If you wish to cancel the right of a third party access to your confidential financial and award information, please
complete the box below.
Cancellation of Consent for Third Party Release
I wish to cancel my authorization for the Santa Ana College Financial Aid Office to release my confidential
financial and award information to the following person:
Name: ___________________________________________________________________________________
Last First Middle
Address: __________________________________________________________________________________
Street Number City State Zip
Relationship: ______________________________________________________________________________
I understand this cancellation is effective on the date received by the Financial Aid Office.
_______________________________________________ ______________________________________
Student Name (Print) Student Signature
__________________________ ________________________ ____________________
Student’s Soc.Sec.No Student’s SAC ID Date
H: Department Directories/Financial Aid/FORMS/2019-2020/Third Party Release Rev. 3/27/19
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