Parental Access to Student Records Form

AFFIDAVIT

Under FERPA, the university may (but is not required to) release any and all information to parents without the consent of the student, if the student is a dependent for tax purposes under the IRS rules. To verify dependent status, university offices should request some written confirmation from the parent, such as an e-mail, faxed, or mailed statement, or copy of the first page of the parent’s most recent tax return showing the student as a dependent, with money figures redacted. If either parent carries the student as a dependent, then both parents have access to the information.

Date: ______________________________________

Parent Name ______________________________________

(Please print)

Address ______________________________________

City, State, Zip ______________________________________

1. I am a parent of the Texas State University-San Marcos 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.

3. I claimed my child as a dependent in the most recent tax return I filed with the IRS.

Student’s Name ______________________________________

Student’s SSN ______________________________________

Records Requested ______________________________________

I understand that this affidavit is valid only for the current semester, and must be presented for each transaction.

Sworn to and subscribed before me this _______________ day of ________________, _______.

________________________________________________

Notary Public

Updated 7/27/09