University of Washington
Student Fiscal Services

Student Aid Authorization - Form 3
Authorization to Override Form 1 Restrictions

New Revision Cancellation

Required Information:
Aid Year 2008-09 (Sum 08 - Spr 09) 2007-08 (Sum 07 - Spr 08) 2006-07 (Sum 06 - Spr 07) 2005-06 (Sum 05 - Spr 06)
Budget Number	Budget Name
Department	Box #
Contact Name	Email (please use complete address ie: johndoe@u.washington.edu)
Phone

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A. Override this Fund to Pay:

Non-resident Tuition	Non-resident over 18 credit hour surcharge
Resident Tuition - Building Fee	Resident over 18 credit hour surcharge
Resident Tuition - Operating Fee	Student Insurance
Resident Tuition - Services & Activities Fee	Lab and Course Fees
Resident Tuition - Technology Fee	Housing Charges
Resident Tuition - IMA Bond Fee	Penalties and Fees
	Other (please specify)

B. Override this Method of Disbursement

Cash only (aid check/direct deposit)

Credit student's account only (will pay tuition and other charges)

Credit student's account and remainder will disburse as cash

C. Override Student Restrictions Applicable to this Fund (OPTIONAL)

Restrict disbursement to students who meet the following requirements:

Resident Code (1-2) Non-resident Code (3-6) Minimum GPA

Class		College		Major		Min Cr Hrs
Class		College		Major		Min Cr Hrs
Class		College		Major		Min Cr Hrs

Class Codes
1=Freshman	2=Sophomore	3=Junior	4=Senior	5=Fifth year	6=Non-matric
8=Graduate	11=1st year prof.	12=2nd year prof.	13=3rd year prof.	14=4th year prof.

 

Student #	Name	Total Amnt SUM	Total Amnt AUT	Total Amnt WIN	Total Amnt SPR

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