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Reason For Return (Bursar Office staff only)  ______________________________________________________________________________ Borrower Signature Date ______________________________________________________________________________ Bursars Office Authorized Signature Date     Return of Financial Aid FundsOne Washington Square, San Jos, CA 95192-0138 Revised 5/6/21 Student Name: __________________________ ID#: _____________________________ Borrower Name: _________________________ Borrower SSN: ___________________ (Parent Plus Only) (Parent Plus Only) Original FA Disbursement: $_____________ Return Amt: $ ____________________ Fund Source: ___________________________ Semester: ________________________ Daytime Phone #: __________________________________________________________ E-mail address of borrower (student/parent): _______________________________ The financial aid award(s) need adjustment because the student or borrower: Is no longer eligible for funds. 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