UNIVERSITY OF SANTO TOMAS

Office of the Vice Rector for Finance

APPLICATION FOR REFUND OF FEES (Under the Pandemic)

I, ________________________, a student of the college/faculty/school of _________________

hereby apply for a refund of part of my fees and/or fee adjustments for the reason that (check
appropriate blank below):

_____ I graduated/met all the academic requirements for graduation at the end of the
____________Term of AY 2019-2020 and had paid fully my accounts for that term

_____ I am currently enrolled as a _____ year student and have fully settled my accounts for the 2nd Term
of AY 2019-2020, Special Term of AY 2019-2020, (if applicable), and the 1st Term AY 2020-2021

_____ I am not currently enrolled but have fully settled my accounts as a _______ year student in the 2 nd
Term AY 2019-2020 and/or Special Term AY 2019-2020 (if applicable)

_______ Refundable amounts exceed all my remaining balances in the previous term(s)

I wish to claim my refunded amount through (check appropriate blank):

Bank Name/Branch: ___________________________________________

_____ Bank
Account Name: _______________________________________________
Transfer Account Number: _____________________________________________

To be claimed from the UST Cashier’s Office

_____ Check 2nd floor, Main Building, UST Campus (if allowed by quarantine level
conditions)

CERTIFICATION
This is to certify that based on records and per computation, the total amount to be refunded to the
aforementioned student is _________________________________________________.

Prepared by: Checked and Verified by: Approved by:

_________________________ _______________________________ _________________________ S

Staff in Charge Supervisor, Student Accounts Section Vice-Rector for Finance

UST:S004-04-FOO7