CALIFORNIA STATE UNIVERSITY CHICO
FINANCIAL SERVICES
STUDENT FINANCIAL SERVICES
STUDENT SERVICES CENTER
ROOM 230
CHICO, CA 95929-0242
530-898-5936
www.csuchico.edu/sn
TERMS OF AGREEMENT
I understand that I am responsible for verifying with my bank that my account has been credited. •
I understand that expenditures made from my account without such verication will be made at •
my own risk.
I agree to promptly notify CSU, Chico of changes in my address or checking account status.•
I authorize CSU, Chico to initiate credit entries and, if necessary, to initiate debit entries and adjustments •
for any credit entries in error to the account specied below.
I authorize the nancial institution named below to process the credit and/or debit entries initiated •
by CSU, Chico.
Prior to a refund being issued, an audit is made on the student account to verify charges and to •
determine the actual amount that should be refunded to the student, to nancial aid programs, and/or to
pay other University debts.
Parent Plus Loan
Direct Deposit
Purpose: Intended for parents receiving parent plus loans who wish to receive disbursement via direct deposit.
INS
TRUCTIONS FOR COMPLETION OF THIS FORM
Read the Terms of Agreement & Authorization below.•
Fully complete the form. •
Sign, date, and print the form.•
Make a copy for your records.•
Attach one of your pre-printed checks to the form. Write “VOID” across the face of the check.•
Submit the original completed form • (sorry, we cannot accept a fax copy of this form), including the terms
section, to: CSU, Chico, Student Financial Services, Chico, CA 95929-0242.
AUTHORIZATION
Parent Name:
Parent Date of Birth:
Student Name:
Chico State Student ID:
Parent Email Address:
Financial Institution: Bank Account Number:
Parent Signature:
Date:
SFIN: Parent Plus Loan Direct Deposit Updated July 2014
ATTACH VOIDED,
PRE-PRINTED
CHECK HERE
