Get Direct Billing Authorization - University Of Rochester - Rochester

Completing the Direct Billing Authorization form for the University of Rochester allows direct billing to your employer for tuition and fees. This guide provides clear instructions on each section of the form to ensure accurate submission.

Follow the steps to complete your Direct Billing Authorization form accurately.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the Employer Agreement section, enter the company name of the employer or sponsor responsible for payment.
3. Obtain the authorized signature from a designated representative of the employer. Ensure they print their name and title clearly below the signature.
4. Provide the billing address, including city, state, and zip code, to ensure accurate correspondence.
5. Include a contact phone number and email address for the employer or sponsor in the respective fields.
6. In the Payment Schedule section, mark the academic year for which the billing applies and note the due dates for each term.
7. In the Student Agreement section, you (the student) must sign and date the form, providing your printed name and student ID number.
8. List the courses or labs you are registering for in the provided fields, along with their associated fees.
9. Sum the total amount to be paid in the designated area at the bottom of the form.
10. Once you have completed all sections, save your changes, then download or print the form for submission.

Ensure a smooth billing process by completing your Direct Billing Authorization form online today.