Late Fee Appeal Form

It is assumed that you are aware of the tuition fee schedules, late payment penalties, refund schedules, and deadlines.

If there are questions about the accuracy of any terms or if you are seeking payment arrangements see the Student Billing Office, Room SS1300, before completing this form.

If you wish to file an appeal, complete the following:

First Name:
Last Name:
Campus ID:
Campus Email:
Current Mailing Address:
Daytime Phone:	( ) - Second three digits Last four digits
Semester for Appeal:	ex: Fall 2019
Explanation:	Please give detail of the charges being appealed and reason for appeal. Be sure to include all appropriate dates, in sequence.
Supporting Documentation:	If necessary, please upload any supporting documentation.