THE UNIVERSITY OF MAINE

LATE FEE WAIVER FORM

Please Check Applicable Term(s) and Enter Year

Fall _______Spring ________Summer ________Year_________

Name: _________________________________	Date: __________________________
Address: ________________________________	ID#: ___________________________
_______________________________________	Phone # ________________________

Reason(s) fee should be waived (Please be specific):

Attach all confirming documents and return this completed form to the Bursar’s Office. A copy will be returned to you with the response.

-BURSAR’S OFFICE USE ONLY-

Approved _________ Denied _________ Pending _________ By: _________ Date: _________

Reason(s) for denial:

____________________________________ _____________

Bursar or Associate Bursar Date

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