The amount on the RFF must correspond with the individual refunds submitted. For example, if funds for CAL, BOT, and TASSP are all being returned, three separate RFFs will need to be submitted and three refunds should be processed

Date: 05-27-2020 FICE Code: Institution:
Contact Information
Position Name Email Phone
Financial Aid Director
Reporting Official
Business Office Contact
Program Total refund: PCA#
Disbursement Year: Calendar year the funds were disbursed        Term: = Fall      S = Spring      SM = Summer       Award: F = Full       P = Partial
Explanation: INST Canceled = Institution Initiated Cancelation         STDNT Canceled = Student Initiated Cancelation
Common Line Unique ID Disb.
Disb. Year Term Fall Spring Amount(Exclude all Fees) Award First Name Last Name D.O.B