Title IV Opt-Out Request

Title IV financial aid includes aid from the Pell Grant, Supplemental Educational Opportunity Grant (SEOG), Direct Loan, and PLUS Loan programs.

The terms of the Financial Responsibility Agreement, which all Cornell students must submit, grant authorization to allow Federal Title IV financial aid, except for Federal Work Study wages, to be applied to all charges assessed to your student account, including any outstanding balance for tuition, fees, room and board, student health insurance, parking permits, bookstore charges, service fees and fines. 

Students have the option to withdraw this authorization. 

If you withdraw authorization:

• Federal Title IV financial aid will not be applied to charges other than those for tuition, certain fees, housing and dining.  Other education-related charges that are assessed to the student account, such as student health insurance, parking permits, bookstore charges, service fees and fines, would therefore need to be paid by other means.
• Title IV funds will be refunded while account balances remain due and payable.  Students who choose to withdraw their authorization must take special care to monitor their bills to ensure they pay all charges by their due dates.

To withdraw Title IV authorization:

1. Print and complete the form below.
2. Mail the form to the address printed on the form.

The Bursar’s office must receive the form at least two weeks before the start of a term for the withdrawal authorization to effect how aid is applied for that term and all subsequent terms.

If after previously withdrawing your authorization you would like to reauthorize Cornell to apply Title IV funds to all allowable charges, please contact the Office of the Bursar for instructions. Reauthorization is not retroactive or instantaneous.

Title IV Opt-Out Request (PDF, 108 KB)