Follow the steps to complete your payment request form online.

1. Press the ‘Get Form’ button to access the Extended STR Payment Request Form and open it in your browser.
2. Begin by entering your full name and Social Security Number (SSN) in the designated fields. Ensure that the information matches your official records.
3. Provide your current mailing address, including city, state, and zip code. Accurate contact information is crucial for correspondence regarding your reimbursement.
4. Enter your preferred email address and phone number. These will be used for communication related to your form submission.
5. Select the appropriate degree type you are pursuing by checking the corresponding box. Options include undergraduate or graduate certificate, associate, baccalaureate, master’s degree, professional degree, or doctorate.
6. Indicate the number of credits you have completed during the applicable terms. This information informs your eligibility for reimbursement.
7. Fill in the total number of credits attempted and the eligible credits for reimbursement. Also, state the tuition charged for the term, ensuring it reflects the actual fee statement from your institution.
8. Indicate whether you have a Minnesota Direct Deposit Authorization for EFT form on file or attached by initialing the appropriate box.
9. Answer the questions regarding federal GI Bill payments and ROTC scholarships. Provide the respective amounts when required.
10. Include any additional remarks if necessary, and review all the information you have provided for accuracy.
11. Sign and date the form to confirm your understanding of the responsibilities related to the Minnesota State Tuition Reimbursement program.
12. After completing the form, ensure all required documents (grade report and final fee statement) are attached. Save changes, and proceed to download, print, or share the completed form.

Submit your Extended STR Payment Request Form online today to ensure timely processing of your tuition reimbursement.