Fillable TITLE IV CREDIT BALANCE AUTHORIZATION FORM STUDENT - (George Washington University)

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TITLE IV CREDIT BALANCE AUTHORIZATION FORM STUDENT - (George Washington University)

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STUDENT ACCOUNTS OFFICE
800 21
ST
ST NW – GROUND FL - WASHINGTON DC 20052
PHONE: 202-994-9000 FAX: 571-553-1099
EMAIL: refunds@gwu.edu
STUDENT -
TITLE IV CREDIT BALANCE
AUTHORIZATION FORM
The Higher Education Act requires that Title IV funds are to be is to be used for authorized charges in the form of tuition, fees, and
room and board as assessed by the University. Title IV funds include: Federal Pell Grants, Federal Supplemental Educational
Opportunity Grants (FSEOG), Federal Perkins Loans, Federal Work-Study, Federal Direct Stafford Loans, Federal Direct PLUS Loans
and TEACH Grants. Fees assessed by the University such as library fees, health center fees, security fees for housing, are not
authorized charges for which Title IV funds can be automatically applied.
As required by the Higher Education Act, any Title IV funds awarded to a student in excess of these charges must be refunded to the
student. A Title IV credit balance will be automatically applied to the student no later than fourteen (14) days of the crediting of such
funds to the student’s account. Credit balances as a result of Federal Direct PLUS Loans will be refunded to the parent, if the parent
is the borrower.
Federal regulations governing how Title IV funds are processed (34 CFR 668.165(b)) allow for students or parents to voluntarily
authorize the University to handle Title IV credit balanced in different ways. Students can authorize the university to hold on behalf
of the student any Title IV credit balances and apply such Title IV credit balances to a future semester. Students can authorize the
University to apply Title IV credit balances to non-authorized charges. Parents who have borrowed under the Federal Direct PLUS
Loan program on a student’s behalf can authorize that any applicable Title IV credit balance be disbursed to the student. These
authorizations are completely voluntary and can be revoked at any time. Any such authorization or revocation of an authorization
takes effect as of the date of the indicated on this form.
To exercise one or more of these authorizations, please complete and submit this form.
GW Student Name:
___________________________
___________________
_____
GWID:
___________________
LAST
FIRST
MI
AUTHORIZE
CANCEL
AUTHORIZATION
CREDIT BALANCE AUTHORIZATION
USE TITLE IV FUNDS TO PAY FOR EDUCATIONALLY RELATED CHARGES
I authorize The George Washington University to apply any applicable Title IV credit balances as a
result of excess Title IV student financial assistance which I have been awarded
HOLD CREDIT BALANCE RESULTING FROM TITLE IV FUNDS
I authorize The George Washington University to retain credit balances resulting from Title IV
funds (except for Federal Direct PLUS Loans, if the parent of a dependent undergraduate is the
borrower) and apply them to future semester institutional charges or other educationally related
charges that I may incur. I understand that by selecting this option I will not receive a refund for
any credit balance for which I may be due unless I specifically request the refund at a
subsequent point in time.
USE TITLE IV FUNDS TO PAY PRIOR YEAR CHARGES
I authorize The George Washington University to use Title IV student financial assistance which I
have been awarded and which I have accepted to pay up to $200 for prior year charges for
tuition, fees, and room and board I have incurred during the prior award year.
USE FEDERAL WORK-STUDY EARNINGS FOR EDUCATIONALLY RELATED CHARGES
I authorize The George Washington University to use Federal Work-Study earnings for the
current term towards my University charges. I understand that by filing this authorization I will
not receive a paycheck for my Federal Work-Study earnings.
USE FEDERAL WORK-STUDY EARNINGS TO PAY MINOR PRIOR YEAR CHARGES
I authorize The George Washington University to use my Federal Work-Study earnings for the
current term to pay educationally related charges for a prior award year. (FWS funds, combined
with other Title IV funds, used to pay prior award year charges cannot exceed $200).
I understand that this is a voluntary authorization and that I may revoke this authorization by submitting a subsequent form
canceling this authorization.
Signature: ____________________________________________________________ Date: ________________________________
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TITLE IV CREDIT BALANCE AUTHORIZATION FORM STUDENT - (George Washington University)

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Completed 23 September 2021

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