Attachment II
Affidavit
Parental Access to Student
Records
Date:
Affiant Name: ______
Address: ______
________________
Affiant swears
that the following statements are true:
1. I
am a parent of the Texas State student listed below.
2. I
am requesting a copy of the records listed below. I understand that there may
be a fee charged for some documents, such as $5.00 for a transcript.
3. My
child is a dependent student as defined in Section 152 of the Internal Revenue
Code of 1986.
Student's
Name:
Student's
SSN:
Records
Requested:
______
Affiant's
Signature
Sworn to and
subscribed before me this day of ,
______.
Notary
Public, State Of Texas