Statutes, codes, and regulations
California Code Of Regulations
Title 5 - EducationDivision 4 - California Student Aid CommissionChapter 1 - California Student Aid Commission
Article 4.5 - Cal Grant Program Appeal Process and Appeal Criteria
Appendix A - Csac Appeal Certification Form

Cal. Code Regs. Tit. 5 , 4.5 app A

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Current through Register 2024 Notice Reg. No. 25, June 21, 2024
Appendix A - Csac Appeal Certification Form

Purpose: The purpose of this form is to certify institutions, who have lost eligibility during the certification process, and wish to appeal with the commission in accordance with California Education Code 69432.7. Use this form to determine if your institution is qualified to appeal based on your cohort default rate and/or graduation rate.

Instructions: Please make sure all fields are completed. If qualified, send this form with a formal letter of request to appeal along with supporting documents. If you select NO at any point, your institution is not qualified to appeal. If you determine your institution is not qualified based on this form, no further action is required.

Institution Name: ________________________________________

OPE ID: ______________________________

Contact: ____________________ Email: ______________________________

Phone: ____________________

Please certify and complete the following:

1. My institution remains eligible for Title IV programs: [] Yes / [] No

2. My institution's cohort in question is 20 students or less for academic year _____: [] Yes / [] No

3. My overall institution Grad Rate for academic year _____ is above 30% [] Yes / [] No/ [] N/A

4. The number of students that are listed on your roster for the current academic year: __________

5. The number of students that have received payment on your roster for the current academic year: __________

6. Attach a formal letter of appeal on school letterhead and include supporting documentation that you will use for your appeal.

I understand the commission is bound by the California Education Code 69432.7 and related regulations and is not permitted to make any exceptions for any reason for institutions that do not meet the statutory criterial for granting an appeal. [] Yes / [] No

Print Name: ___________________________________

Date: ___________________________________

Signature: ___________________________________

(Should be signed by the official who signed the Institutional Participation Agreement)

Cal. Code Regs. Tit. 5 , 4.5 app A

1. New Appendix A filed 9-21-2021; operative 1-1-2022 (Register 2021, No. 39). Filing deadline specified in Government Code section 11349.3(a) extended 60 calendar days pursuant to Executive Order N-40-20 and an additional 60 calendar days pursuant to Executive Order N-71-20.