PORTLANDSTATE

UNIVERSITY

PETITION FOR WAIVER OF

STUDENT I.D. CARD REPLACEMENT FEE

Return to:

Portland State University, ID Services Office, P.O. Box 202, Portland, OR97207. For more information please call (503) 725-8333 or visit our website at

and return as an attachment via email

Instructions:

This petition must be completed and submitted within fourteen (14) calendar days after the card replacement fee is applied to your account or the petition will be automatically denied.

You will receive notification of the resulting decision in about 2 – 4 weeks.

PLEASE PRINT CLEARLY OR TYPE:

Today’s Date:
Student I.D. Number:
Email Address:
Primary Phone Number:
Name:
Address:
City & State
Zip Code:

Please state reason(s) for requesting waiver below:

I certify that the above is a true and accurate statement of my appeal.

  1. PSU is not responsible for lost or stolen cards
  2. Student responsible to update address
  3. Documented student was informed of $21.00 fee for replacement cards
  4. Partial waiver – Reason undetermined or 2nd card sent to same address
  5. Other
  6. Approved

Decision: / Date:
Committee Comments:

You may request an appeal to this decision by completing the waiver petition within 15 days of notification. These forms are available at the Cashiers / Student Accounts / ID Services windows in Neuberger Hall.

Mailed by / Date

It is important to know that the committee reviews each request individually. In the evaluation process, careful consideration is given to complete and accurate information. Please be as specific as possible as we compare specific dates of address change with card processing and distribution.

Things to know that will work in your favor when evaluating requests.

  1. Print clearly – this is important so that it can be read and understood.
  2. Use your current mailing address in the form.
  3. State your case and make your request. Petitions that are unclear or do not have a desire outcome may not yield the desired results.
  4. Help us help you. We can only render a decision based upon the available information.
  5. Incomplete forms will not be processed or returned.

Card Replacement Waiver Petition V2.3.doc9/11/2018

Ver. 2.4