Office of Veterans Affairs | (850) 201-8406 | Fax (850) 201-8980

444 Appleyard Drive | Tallahassee, Florida 32304 | (850) 201-6200 |www.VABenefits@tcc.fl.edu

TCC Veteran Deferment or Third Party Contract

First Name: * ASHLON MI: j Last Name: * FOUNTAIN Email: * fount486@mymail.tcc.fl.edu

Date of Birth: * 10/27/1995 TCC ID Number: * A18002527 Phone: * (315) 804-0116

ex. MM/DD/YYYY ex. (###)-###-####

WHAT IS A VETERAN DEFERMENT? A deferment or Third Party Contract is a method of extending the tuition payment deadline. The deferment
temporarily lifts the tuition liability. This means that, for a short period of time, students are placed in a "hold" status for unpaid tuition on their account. If,
for some reason, a determent is placed on an account and the anticipated funds do not arrive, it is the responsibility of the student to pay all accounts in full.
Remember, any unpaid tuition that remains unpaid after the tuition payment deadline will be sent to a collection agency and additional fees may be added.
Students are encouraged to check their Account Statement often in order to avoid any unexpected pitfalls that may arise around deferments.

PLEASE DO NOT COMPLETE THIS FORM UNTIL YOU HAVE DONE THE APPLICATION FOR VA EDUCATION BENEFITS

DEFERMENTS EXPIRE BEFORE THE END OF THE SEMESTER

FORMS SUBMITTED AFTER 4:00 P.M. WILL BE PROCESSED THE FOLLOWING WORK DAY

REGISTRATION MUST BE COMPLETE BEFORE SUBMITTING DEFERMENT REQUEST

Before you apply for a deferment, please ensure your schedule is complete and that you have requested VA certification for the
semester.

What VA education benefits have you applied for?

b
c
d
e
f
g Chapter 33 (post 9/11 veteran)
c
d
e
f
g Chapter 30 (Veteran Montgomery GI Bill)
c
d
e
f
g Chapter 33 (Transfer of entitlement) (Post 9/11 Dependent/Spouse)
c
d
e
f
g Chapter 1606 (Selected Guard/Reserve)
c
d
e
f
g Chapter 1607 (REAP)
c
d
e
f
g Chapter 31 (Vocational Rehab)
c
d
e
f
g Chapter 35 (Dependent/Spouse of Disabled or Deceased veteran)

Which semester are you requesting a deferment for? (You may only select one semester per form.)
* Summer Semester  * 2018

ex. (####)

What is the total tuition/fees indicated on your Account Summary?

* $ 1,000.0

ex. ($#,###.##)

If you anticipate any of the following, do not apply for a VA deferment unless you expect to owe a balance after any of these have paid. You must first work
through your unit or education office to obtain an approved Third Party/Agency Billing Agreement or Authorization form such as ROTC Tuition Scholarship,
Military tuition Assistance (TA), education Dollars for Duty (EDD), State Waiver or Purple Heart Waiver. If Military TA and EDD are primary and you have not
received the approved authorization form from your education office, please request a deferment.
* g
b
c
d
e
f I have read and understand this statement.
 Please check the box after reading each item:
* g
b You must immediately report any enrollment changes (drops or withdrawals) to the Office of
c
d
e
f
Veterans Affairs.
* g
b Charges must be paid to the CASHIER'S OFFICE by the expiration date. The Cashier's Office is
c
d
e
f
located in the Student Union Building, 2nd Floor. Fees can also be paid on-line via TCC Passport.
* g
b Should you fail to pay tuition or fees by the appropriate deadline, you will forfeit your right to
c
d
e
f
receive future deferments.
* g
b If the VA should deny or withhold education benefits, you will remain liable for fees. Should you
c
d
e
f
withdraw during the semester, you remain liable for the fees deferred.
* g
b If fees are not paid or deferred by the tuition payment deadline date, your indebtedness will be sent
c
d
e
f
to a collection agency and additional fees will be assessed.

CONDITIONS
* g
b It is the student's responsibility to make payment or defer payment within the appropriate date
c
d
e
f
without regard for the College's billing procedures or postal delays.
* g
b If enrollment is terminated for any reason, the unpaid balance of tuition and fees is due and
c
d
e
f
payable immediately. Students who fail to make full payment of tuition and fees by the due date
may be prohibited from registering for classes until full payment is made.

ATTENTION
Military TA, MyCAA and EDD are primary. Please attach a copy of your approved military authorization for FTA or FLNG 704 EDD Application.
Upload one PDF document (can be multiple pages)

AUTHORIZATION
I give my permission for the school certifying official to review my educational record.
I acknowledge and understand that this form has been created through, and is administered by TCC Office of Veterans Affairs. The form is secure, and the data is
accessed only by appropriate college officials. By completing this online form I am consenting to the sharing of the information contained herein with appropriate
college officials as deemed necessary by Tallahassee Community College, and solely for purposes related to processing my request.
If you DO NOT consent to the use of electronic submission for processing this form, please visit the Office of Veterans Affairs located in the Moore Veteran
Success Center, CT 206, to fill out a hard copy of the form.

Sign this form

By signing on the next page, the student acknowledges and confirms that the above is complete and correct, and affirms that he/she has read,
understands, and will abide by the information contained herein.

*******Veterans Affairs Office Use Only*******

APPROVED - Amount of tuition & fees eligible for deferment:

ex. ($#,###.##)

Student Signature Electronically signed by ASHLON FOUNTAIN on 05/07/2018 3:24:13 PM

Coordinator, Veterans
Electronic Signature Pending
Affairs Signature