Title IV Funds Authorization Form

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Federal Title IV funds (Federal Pell, Perkins, SEOG, and all loan funds) received by Eastern Kentucky University are automatically applied to student accounts first to cover tuition and fees and on-campus room and board. Any remaining funds may then be applied to other charges on your account ONLY with your authorization.

This authorization is valid for your entire period of enrollment at EKU and may be rescinded in writing at any time by contacting the Division of Student Accounting Services. Without this authorization, payment for other charges must be remitted by the due date on your fee bill.

Please sign below to authorize the university to apply any remaining Federal Title IV funds to other charges.

I, (print name), authorize Eastern Kentucky University to apply any remaining Federal Title IV funds to other charges that I may incur.
Signature
Date
Student ID

Return completed form to:

Division of Student Accounting Services, EKU 521 Lancaster Ave., SSB CPO 60, Richmond, KY 40475-3102


Office Use Only
Posted by	Date
Rev. 7/2001