Form Tr-0383 - Payment Request printable pdf download

accalaureate

ducation

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P.O. B

198786 w N

, TN 37219-8786

ashville

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: 1-888-486-2378 w l

: 615-532-8056

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ree

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: 615-401-6816 w e

mail

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OFFice

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PAYMENT REQUEST:

New

Modify/Override

Additional

Student Name: _________________________________________________________________________

Social Security Number: ____________________________

Contract ID: _________________________

Preferred Method of Contact

: ____________________________________________________

(phone, email)

This form may only be completed by the Purchaser or Beneficiary of a BEST Prepaid Contract. Each tuition

unit entitles the Beneficiary to an amount equal to one percent (1%) of the weighted average tuition (WAT)

during the academic year in which the unit it used. The WAT unit payout value is recalculated annually

on August 1

and is effective until July 31

of the following year. Please contact a BEST customer service

representative to determine the number of units that are available on your contract for use. Visit our website

at for information about the current WAT unit payout value.

SECTION A - PAYMENT TO SCHOOL

Payments to Tennessee public schools will be processed once we have received them in our office. A voucher

letter will be mailed to the Beneficiary’s address on record. To confirm the address in our records, please call

our customer service hotline. The Beneficiary should take the voucher letter to the institution. It typically

takes 5-7 business days for you to receive the voucher by mail. Therefore, the payment request form must be

received in our office no fewer than 5-7 business days before the school’s tuition deadline.

For out-of-state schools or private schools in Tennessee, a check will be mailed by BEST directly to the

institution. It typically takes 10-12 business days for the school to receive the payment. Therefore, the

payment request form must be received in our office no fewer than 10-12 business days before the school’s

tuition deadline.

Please enter the name and address of the institution of higher education in this section if you would like

BEST to make a payment directly to the institution.

School Name: ___________________________________________________________________________

Address: _______________________________________________________________________________

(Street)

(City)

(State)

(Zip Code)

Amount Requested: $ ______________ OR Units Requested: ___________

Semester: ___________

Authorization Signature: ____________________________________

Date: _____________________

(See page 2, Section D, for authorization.)

TR-0383 (Rev. 4/15)

- 1 -

RDA-2516

Form Tr-0383 - Payment Request

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