Document Pickup Authorization

This form is used to authorize an individual to pick up a document on your behalf.

Name *
UTA ID # *
Email Address *
I authorize the following individual to pick up the selected document below on my behalf. *
Please select one of the following *

Please select one of the following Official Transcript Enrollment Verification In-School Loan Deferment Letter of Intent Letter of Non-Attendance Diploma Graduation Letter I-20 Other:
If you selected other, please specify the document that is being picked up.
Please attach a copy of your valid government issued photo ID *

Attach Files
*The person picking up your document must also present a valid government issued photo ID for verification purposes.