Student Services Manual (SSM)

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Effective: 7/12/1988

Revised: 11/1/2006

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SSM 203–08: Affidavit of Dependency for Release of Records

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Purpose

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To allow a parent or guardian to request access to a student’s academic records

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Sources

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Family Educational Rights and Privacy Act of 1974 (also referred to as the Buckley Amendment or FERPA), 20 United States Code §1232g (1982)
University Registrar’s Office

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Policy

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A parent or guardian may request access to a dependent student’s academic records by filing an Affidavit of Dependency and a copy of the parent’s or guardian’s most recent signed IRS 1040 form with the University Registrar’s Office or Registration Services at the Polytechnic or West campus. Access is subject to the approval of the appropriate office.

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ProcedureD

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Responsibility
Action
Parent or guardian
  1. Request access.
Academic Files Section or Registration Services at the Polytechnic or West campus
  1. Supply the instructions required and an Affidavit of Dependency.
Parent or guardian
  1. Take affidavit to be notarized.
  2. Return the notarized affidavit with a copy of the parent or guardian’s most recent signed IRS 1040 form to the Academic Files Section of the University Registrar’s Office (SSV 140) or Registration Services at the Polytechnic or West campus.
Academic Files Section or Registration Services at the Polytechnic or West campus
  1. Determine that the affidavit and documents are correct and complete. Release requested records if appropriate.
  2. File the affidavit for reference for two years and cross-reference it on the Student Information System.
Parent or guardian
  1. Renew affidavit every tax year.
endtable

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Cross-Reference

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See also SSM 107–01, “Release of Student Information.”

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