Billing Appeal Form

If you have a question/concern about a Library Billing matter or you wish to appeal/contest a bill, please complete this form. A Library staff person will soon contact you.

First Name

Last Name

Library Barcode Number

Enter the number from your ID.

Phone Number

Email Address

Type of Checkout Billed

General Collection

Interlibrary Loan (ILL)

Reserves (including Laptops and equipment)

Media Center and DSC equipmentMedia Center and DSC equipment

Item Details

For each item, please enter the TITLE, BARCODE and CALL NUMBER.

NOTE: For ILL items, please include the TITLE and the ILL NUMBER located on the bookstrap or overdue notice.

Title	Item Barcode Number	Item Call Number	Operations
Title	Item Barcode Number	Item Call Number

Reason for Appeal

If you are appealing more than one item and the status is different for each item, please use the Explanations/Comments area below.

I am appealing my bill because

I returned the item(s) before the due date

I question the amount of fees assessed

I need more information about my bill

Other reason for appeal

Explanation/Comments

Land Acknowledgement

The land on which we gather is the unceded territory of the Awaswas-speaking Uypi Tribe. The Amah Mutsun Tribal Band, comprised of the descendants of indigenous people taken to missions Santa Cruz and San Juan Bautista during Spanish colonization of the Central Coast, is today working hard to restore traditional stewardship practices on these lands and heal from historical trauma.

The land acknowledgement used at UC Santa Cruz was developed in partnership with the Amah Mutsun Tribal Band Chairman and the Amah Mutsun Relearning Program at the UCSC Arboretum.

University Library

Billing Appeal Form

Land Acknowledgement

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