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
Parent Plus Loan
Direct Deposit
Purpose: Intended for parents receiving parent plus loans who wish to receive disbursement via direct deposit.
INSTRUCTIONS FOR COMPLETION OF THIS FORM
t Read the Terms of Agreement & Authorization below.
t Fully complete the form.
t Sign, date, and print the form.
t Make a copy for your records.
t Attach one of your pre-printed checks to the form. Write “VOID” across the face of the check.
t 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.
TERMS OF AGREEMENT
t I understand that I am r
esponsible for verifying with my bank that my account has been credited.
t I understand that expenditures made from my account without such verication will be made at
my own risk.
t I agree to promptly notify CSU, Chico of changes in my address or checking account status.
t 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.
t I authorize the nancial institution named below to process the credit and/or debit entries initiated
by CSU, Chico.
t 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.
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
click to sign
signature
click to edit
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