Disclosure Statement Form

Federal law requires that we disclose to all students the terms and conditions of repayment of all charges appearing on the Bursar bill.  We are also required to retain a signed copy (either electronic or written) of this instrument of disclosure.

All students enrolled in courses at Cornell must sign the disclosure statement. Not signing a disclosure statement will cause a "hold" to be placed on your university records, which will prohibit registration, receipt of university transcripts, filing for leave of absence, and receipt of your university diploma.

The student must complete the form either online, using the option below, or by visiting the Office of the Bursar at 260 Day Hall.

 Important Note for Online Submitters: The form linked below is for continuing students only. If you are an incoming student in the Fall, please use the form or link provided in your Cornell Bound packet.  You must have an active NetID in order to use this form.  If you do not have an active NetID, please visit the Office of the Bursar to fill out a paper copy.

 Complete Following Form:

 Sign Your Disclosure Statement

 Note: This online form submission service is provided by the Office of the University Registrar. Online submission will affect your Bursar account within two business days.

If you have signed or submitted a disclosure statement already, it does not need to be resubmitted.  You only need to sign or submit one disclosure statement for your entire Cornell career.