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The Family Educational Rights and Privacy Act of (Spokane Community College)

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CCS 2138(Rev. 03/18)
Marketing and Public Relations
Community Colleges of Spokane
AUTHORIZATION TO RELEASE FINANCIAL INFORMATION
Spokane Community College • Spokane Falls Community College • Institute for Extended Learning
INSTRUCTIONS
The Family Educational Rights and Privacy Act of 1974 prohibit access to a student’s education
records (other than “directory information”) without the written consent of the student. These
confidential records include financial aid, scholarship and billing/account information.
Students may authorize others access to their Community Colleges of Spokane financial records
using the following methods:
1. Provide their student ID number and PIN to allow access to that information on-line.
a. Students who later wish to deny access to must change their PIN.
2. Complete the attached Authorization to Release Financial Information form identifying those
that they would like to have access to their financial records. The release will require the student
to choose a password that they will provide to the authorized person(s) listed on the release in
order for the person(s) to call and request information. The authorized person(s) will provide the
password to CCS staff before gaining access to the information.
a. Students who later wish to deny access that has already been granted must revoke the
release in writing.
b. A new release must be submitted to add, delete or change information on the release
c. Upon request from the student, the student will be provided a copy of the records disclosed.
RELEASE FORMS
Please send completed release forms to your nearest local campus cashier’s office or mail to:
SCC Cashier MS 2155
1810 N Greene St
Spokane WA 99217-5399
SFCC Cashier MS 3171
3410 W Fort George Wright Dr
Spokane WA 99224-5288
Please complete release form
CCS 2138(Rev. 03/18)
Marketing and Public Relations
AUTHORIZATION TO RELEASE FINANCIAL INFORMATION
The Family Educational Rights and Privacy Act (FERPA) of 1974 is designed to protect the
privacy of a student’s educational records. These confidential records include financial aid,
scholarship and billing/account information, and will not be released without written consent from
the student. By signing this form, the student authorizes college personnel to release confidential
information to designated person(s).
Student name
Student ID number
I authorize Community Colleges of Spokane to discuss my confidential financial account
information for the purposes of understanding and meeting college related financial obligations
with me or any of the person(s) listed on this form.
I understand that the person(s) listed on this form will have access via telephone, in person, or
mail to information that may include the following:
• My financial aid and scholarship records, including processing and eligibility status as well as
award types and amounts. This information will not include specific parental income or asset
information.
• My tuition billing account and statements, including credits and debits posted to that account
and any
refund amounts that I have received.
This authorization form does not allow the college to release specific academic information.
Requests to
release academic information will be handled by the Registrar’s Office.
Name(s) of people to release information to: (please print)
Authorization password
(Please limit the password to one printed word. The authorized person(s) listed above will be
expected to know this information.)
This authorization will remain in effect until revoked in writing by the student.
I certify, under penalty of perjury, that the number shown on this form is my correct student
identification
number (SID) and I am the individual listed above.
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Completed 27 July 2020

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