Authorization to Release Information - Student Financial Services

Sep 17, 2026

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This Authorization to Release Information form, provided by the Student Financial Services office at La Salle University, serves as a formal consent document for students to grant access to their private financial aid files and academic records. By completing this document, students explicitly authorize designated individuals to receive information pertaining to their enrollment period. The form outlines necessary security protocols, requiring authorized parties to verify specific personal data, including the student's ID number, date of birth, and the designated individual's own sensitive information, such as the last four digits of their Social Security number and date of birth, ensuring strict compliance with the Privacy Act of 1974. This document remains valid throughout the student's enrollment unless formally updated or modified by the student, providing a secure and flexible framework for managing access to sensitive personal information while maintaining regulatory standards.

LanguageEnglish

CategoryForms

FormatPDF

Pages1

AccessFree to download

Authorization to Release Information

Student and Designated Individual Details

Terms and Conditions of Release

Signature and Submission

FAQs

What is the purpose of this form?

This form authorizes the Office of Student Financial Services to release a student's financial aid and academic records to specifically designated individuals.

What information must authorized individuals provide to access records?

Designated individuals must verify the student's ID number and date of birth, and provide their own date of birth along with the last four digits of their Social Security number.

Does this form need to be renewed annually?

No, the form does not need to be renewed unless the student makes a change to the list of authorized individuals or wishes to update their permissions.

Sep 17, 2026

Upload by Marry