BRIARCLIFFE,

Authorization for Title I V Financial A i d Funds

Student/Parent Authorizations
Under federal guidelines, Title I V financial aid funds will be credited to the student's account, without separate authorization, for tuition, required fees, and room and board (if contracted with the school). I authorize Briarcliffe College - Online to take the following actions regarding Title IV financial aid funds (draw a line through any statements below that you do not wish to authorize): 1. Title IV funds may be used for other current educationally related charges applied to my student account at the school including, books, supplies, and any other direct or indirect charges. 2. Credit balances that may result from the crediting of Title IV financial aid funds to my student account may be retained and applied to allowable future charges incurred to my student account. In authorizing retention of any such credit balance, it is understood that I will receive no interest on the funds that are retained. 3. Credit balances that may result from the crediting of Title IV financial aid funds to my student account may be applied to prior award year charges of no more than $ 200 that were charged to my account and not previously paid, as long as payment of the prior award year charges will not prevent me from paying current educational expenses. 4. If, upon my leaving school through graduation or withdrawal, a credit balance exists on my student account after all Title IV refunds and tuition adjustments have been made, the credit balance may be applied to my Federal Stafford Loan and/or my PLUS Loan to reduce my outstanding loan balance. I voluntarily make the above authorizations and understand that I may modify or rescind the authorizations at any time through written notification to the Financial Aid Office. I understand that I will be required to make cash payments for any charges for which I do not authorize use of Title IV funds.

J}J9(2' Student (borrower) Dirte / To be Signed by PARENT B O R R O W E R - if Federal Parent-PLUS Loan

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Printed Name of Student

Last 4 digits of SSN

Signature of Parent

Date

Printed Name of Parent

Last 4 digits of SSN

Other Non-Title I V Funds Authorization In addition to Title IV funds, I may receive non-Title IV financial aid funds, including but not limited to private scholarships, state grants and/or private loans (referred to here as "Other Funds"). I authorize Briarcliffe College - Online to take the following actions regarding Other Funds (draw a line through any statements below that you do not wish to authorize): 1. Other Funds may be used for all educationally related charges applied to my account, including tuition, fees, books, supplies, and an) other direct or indirect charges. Credit balances that may result from the crediting of Other Funds to my student account may be retained and applied to future charges incurred and charged to my account. I understand that 1 will receive no interest on the funds that are retained. Credit balances that may result from the crediting of Other Funds to my student account may be applied to outstanding charges from prior years, as long as use of such credit balance will not prevent me from paying current educational expenses. If, upon my leaving school through graduation or withdrawal, a credit balance exists on my account, such credit balance will be used to reduce any loan indebtedness of my Other Funds by returning such credit balance to my lender. I voluntarily make the above authorizations and understand that I may modify or rescind the authorizations at any time through written notification to the school Financial Aid Office. I understand that I will be required to make cash payments for any charges for which I do not authorize use of Other Funds.

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Signature of Student

Date

Printed Name of Student

Last 4 digits of SSN

Effective: 6-30-03:4-28-04:11-12-07: P r Y r A m t { 2 0 0 , 2 - 1 8 - 0 8 : SSN to 4 digits 5-15-09 Add Parent to PIUS 7-21-09: add able to modify 2-II-II: Add other and state 6-14-11 text edits 6-30-1