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University of California, Los Angeles

Retail Cash Disbursement Request

University of California, Los Angeles

In partnership with UCLA Business and Finance Solutions, Convera has established this form to process student refunds through a cash disbursement for students without a U.S. bank account. The student will be required to collect the disbursement in person at a Convera Retail location. You may be eligible for this refund option if:

  • Convera Retail locations are available in your country. Please note: Retail locations are not available in Azerbaijan, Bahamas, Bangladesh, Brazil, India, Iran, Nigeria, Serbia, South Africa, South Korea, Sri Lanka, Turkmenistan, Venezuela.
  • You have government issued identification. Please note: Some countries may require two forms of government issued identification in order to collect funds.

Please ensure all required fields are completed accurately. If you enter any information incorrectly, we will need to reach out to you and correct any errors which may delay the process.

If you have questions regarding available refund methods, please review Business & Finance Services Operations in Response to COVID-19 or contact Student Accounts on the Message Center.

IMPORTANT NOTE: It may take up to 48 hours to create your Convera profile. You will be updated regarding the status of your form once it has been reviewed.


9 Digit UID as provided by UCLA

Select the country in which you are located. Please note: Retail locations are not available in Azerbaijan, Bahamas, Bangladesh, Brazil, India, Iran, Nigeria, Serbia, South Africa, South Korea, Sri Lanka, Turkmenistan, Venezuela, Vietnam.

Select currency in which you would like to receive your funds.

Select state/province you are located in

Student Contact Details

Please provide your contact details below with your full name as listed on your government issued ID

Enter Company or Institution Name.

The name listed must match your government issued ID

Enter Last Name.

Enter Street address of residence.

Enter City of residence.

Enter state/province of residence.

Enter zip/postal code of residence.

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