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Title IV Authorization

Federal Aid Authorization Form

 

The purpose of this form is to obtain your permission to use Title IV funds (Stafford/Unsubsidized loans, Perkins loans, ACG, National SMART, Pell and SEOG grants) to cover miscellaneous expenses (examples listed below) charged on your student account. If there is an excess of funds once the standard costs (tuition, general fee, room and meals) have been paid; your permission is needed in order for the federal funds to cover these additional charges.

If you do not receive Title IV funds, you do not need to complete this form.


Title IV Authorization

I authorize Millersville University to apply Title IV funds to all charges incurred by me. This would include any miscellaneous charges to my student account. Charges covered under this agreement include late fees, key fees, room damage, infirmary fees, meal plans, room premiums, air conditioning charges, orientation fees, ID replacement, and calculator costs.


I authorize Millersville University to use Title IV funds to cover previous semester balances.


Name:

Student ID #:


By checking this box you agree that the information above is correct and that you are the person that the information relflects above.