Office of Student Financial Assistance : Forms

Scholarship Manual Disbursement Request Form

This online form allows IUB staff to request manual disbursement of departmental scholarship funds.

Please allow five to ten (5-10) business days for the Office of Student Financial (OSFA) scholarship staff to process the submitted request. Confirmation will be sent to the email address entered below once the scholarship funds have been disbursed.

Asterisk * denotes required field.

Section 1: Department Contact

Name of requestor*

Phone number *

Email Address *

Department name *

Section 2: Award Information

Aid Year*

Student
ID

1 *

Student
Career

Item Type
Number

Semester to
Disburse

Number Hours Enrolled

Award
Amount

If more than 5 award information requests, please submit another disbursement request form.

Section 3: Enrollment Information

Student has Overseas Study enrollment.
Indicate the type of OVST enrollment in the comment field below.

Student is enrolled in dissertation hours.
Indicate the specific courses in which the student is enrolled in the comment field below.

Student is enrolled less than half-time. (Half-time is defined as 6 credit hours for undergraduates and 4 credit hours
for graduate students.)
Indicate the specific courses in which the student is enrolled in the comment field below.

Student is enrolled in zero-credit hour course(s) for the semester in which the award is posted.
Provide information about any zero-credit hour course(s) listed in Section 2 in the comment field below, and
complete section 4 below.

For timely processing of manual disbursement requests, the OSFA scholarship staff recommends that all submissions include a list of the courses in which the student is enrolled and a brief explanation of the reason for the manual disbursement of scholarship funds. The enrollment described in this section should correspond to the enrollment period for which disbursements are being requested.

Enrollment Comment:

Section 4: Confirmation of Donor Intent

Must be completed if student is enrolled in zero-credit hour course(s).

“Gifts received for the benefit of Indiana University must be spent or utilized according to donor intent. Gifts dollars that are spent in a university account, or gifts-in-kind utilized by the university, are the same as other university resources for the purposes of federal compliance and university policy.” (For more information, please see the Indiana University Financial Institutional Policies relating to Donor Intent Responsibilities at http://www.indiana.edu/~vpcfo/policies/accounting/i-45.html.)

Credit-hour enrollment is not an eligibility requirement for the award(s) listed below.
Indicate any award(s) listed in Section 2 that do not require credit-hour enrollment in the comment field below.

The student(s) listed in Section 2 receiving award(s) that do not require credit-hour enrollment meet(s) all other
scholarship/fellowship eligibility requirements.

Donor Intent Comment:

Office of Student Financial Assistance

Indiana University | Bloomington

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Scholarship Manual Disbursement Request Form