Student Financial Services Late Fee Appeal Form

Please complete this form to request an appeal of a late fee. All required information must be provided for your appeal to be processed.

This form is for enrolled UVA Students or UVAPay Authorized Users. For more information about becoming an Authorized Pay User - Click Here.

Contact Information

I am a:

UVA StudentUVAPay Authorized User

Student First Name

Student Last Name

Student UVA Computing ID

Computing IDs are the first part of your UVA provided email: [computingid]@virginia.edu

UVAPay Authorized User First Name

UVAPay Authorized User Last Name

UVAPay Authorized User Email Address

Appeal Request

Is this your first request for a late fee waiver?

YesNo

What circumstances led to late payment?

Please provide an explanation of your late payment circumstances:

How did you resolve your balance?

Reminder: Your account balance must be resolved before we can consider your appeal.

Please attach documentation of balance resolution at the bottom of this form.

Please provide an explanation of your balance resolution:

Support & Feedback

How can we help you avoid a late payment in the future?

Please provide any additional context and documentation that you feel is relevant to this appeal:

Supporting Documentation (if applicable):

Upload any relevant documents that support your appeal.