iPROMise - Campus Partners

Transcription

User Guide
iPROMise
CAMPUS PARTNERS
2400 Reynolda Road, Winston Salem, NC 27106
Campus Partners
Table of Contents
Overview
3
Borrower Notification
3
iPROMise for Students and Borrowers – Welcome
4
First Time Borrower Page
5
Student/Borrower Registration
6
Registration – Borrower Identity Verification
7
Registration Confirmation Page
8
Log In Page
9
Welcome Page (Home Page)
10
Entrance Counseling
11
Loan Interview
18
Master Promissory Note (MPN)
28
STAN Authentication
37
Total Loan Indebtedness Disclosure (TLID)
45
Cancelled Awards
51
Deleted Awards
52
Unregistered Borrower/ Single Awards
53
iPROMise Login
54
Invalid Login Message
55
Get My User ID/Password
56
Retrieve ID and Password Security Question
57
Appendix
59
1.
Federal Perkins Award File Data Fields
59
2.
Borrower Notification Email
61
3.
HPSL/LDS Multi-Year MPN
62
4.
HPSL/LDS Single Year MPN
65
5.
Institutional Multi-Year
68
6.
Institutional Single Year
70
7.
NSL Multi-Year
72
8.
NSL Single-Year
75
9.
PCL Multi-Year
78
10. PCL Single Year
82
11. Federal Perkins Loan Master Promissory Note
86
12. HPSL, LDS, PCL, NSL Total Loan Indebtedness Disclosure
90
13. Institutional TLID
92
iPROMise User Guide 2015
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Overview
iPROMise, Campus Partners’ online entrance counseling service program, offers a unique
support system to its customers during the financial aid process. It helps the schools manage
the entire student loan process from start to finish. This easy-to-operate package allows
schools to provide Campus Partners with a data file that contains financial aid awards to
borrowers, both new and returning. The full range of services for the borrower is available as a
one-stop shop under the iPROMise flagship and includes:
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Entrance Counseling – A series of multiple-choice questions based on loan type about
rights and responsibilities of a student loan
Loan Interview – This section requires the borrower to enter personal and demographic
information
Master Promissory Note (MPN) – Presented to the borrower based on loan type for
e-signature or mail request for a wet signature
Total Loan Indebtedness Disclosure (TLID) – Presented to the borrower by loan type and
contains the total award amount to date
Customers may choose individual sections of this service or all the components they want for
their borrowers to experience. Borrowers can accept or decline a Perkins, Health Profession,
Nursing, or Institutional award, all through Campus Partners’ online portal,
https://ipromise.campuspartners.com.
Borrower Notification
Customers may choose to have Campus Partners notify their students when their award is
ready for viewing via email, letter, or both. A sample notification can be found on page 61.
After they receive notification from the institute, the student/borrower can access the
iPROMise website, https://ipromise.campuspartners.com. An initial registration by the
student/borrower is required in order to complete the Entrance Counseling session, the Loan
Interview, Master Promissory Note (MPN) and the Total Loan Indebtedness Disclosure (TLID).
Borrowers who do not want to sign the MPN electronically can print their MPN from their
desktop or request a hardcopy of the MPN and TLID be mailed to them.
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iPROMise for Students and Borrowers – Welcome!
The student/borrower can enter the Web site by using the Enter here button at the bottom of
the Welcome page.
Repeat borrowers also have the choice to log in using the Log-in/out button located at the
top right side of the screen.
*First time borrower would need to register before they can log in.
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First Time Borrowers Page
To comply with specific requirements of the Electronic Signatures in Global National
Commerce Act (“E-SIGN”) (Public Law 106-229), the student/borrower will be provided with
the specific hardware and software requirements necessary to access and participate in
electronic records.
In order to proceed, the student/borrower must confirm that their equipment meets the
minimum standards by checking the box, “I certify that I have the required hardware and
software as stated above.”
When the student/borrower selects Continue after choosing their state and school and
confirm that their hardware and software can support iPROMise, the Registration page will
appear on the screen. Exit will return the borrower to the Welcome page.
If a borrower has previously registered, they can select the SKIP TO LOGIN link which will direct
him/her to the Login page.
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Student/Borrower Registration
This page prompts the student/borrower to provide the required Social Security Number, first
three letters of their last name, and date of birth in order to begin the registration process.
Based on the information provided by the borrower, the student’s award information will be
located and the Borrower Identity Verification page will be presented, when the
student/borrower selects the Register button.
Select Exit to go to the First Time Borrower page.
The Login button located on this page will take the borrower directly to the Login page.
*The first three letters of the last name cannot contain special characters. If the borrower
enters a special character, a message will be displayed in red at the top of the Registration
screen and the borrower will be given an opportunity to re-enter his/her information.
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Registration – Borrower Identity Verification
The student/borrower must confirm their identity by checking ‘I certify the information is
correct.’ To proceed further, the student/borrower must select a secret question and provide
the answer to that question.
When each item is completed, choosing Login will allow the registration information to be
processed. Once the registration process has been completed, a user ID and Password will be
provided to the student/borrower on the Registration Confirmation page.
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If the Student/Borrower selects ‘This is not my information’ from the Student/Borrower
Identity Verification page, a pop-up box (illustrated below) will be displayed. When OK is
selected, the student/borrower will be redirected to the Registration Page to re-enter his/her
information.
Registration Confirmation Page
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Log In Page
At this point, the student/borrower (henceforth known as the borrower) is a registered user of
iPROMise. The borrower must select the Log in option to proceed further. After logging in, the
borrower will be presented with links (based on customer options) to Entrance Counseling and
the Loan Interview, which must be completed before accessing the Master Promissory Note
(MPN) or Truth-In-Lending Disclosure (TLID) options.
Alternatively, they may Exit and return to the site at a later date to complete the Entrance
Counseling session.
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Welcome Page (Home Page)
The borrower will be required to complete each section of the loan counseling session
presented in the order shown on the Welcome page (henceforth referred to as Home Page).
The borrower must select the Requires Completion link under each title, starting with the
Entrance Counseling.
When the link for entrance counseling is selected, an Entrance Counseling Test page will be
presented with the school name located at the top of the screen.
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Entrance Counseling
Entrance Counseling-Questions and Answers
The borrower can launch the Entrance Counseling questions and answers section by selecting
the Start button. This section consists of segments of text about their particular loan type
followed by a series of multiple choice question/answers.
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Sample Question/Answer
The borrower should select his or her answer and choose the Submit button at the bottom of
the page for each answer.
Borrowers must answer each question correctly in order to proceed to the next question and
ultimately complete this portion of the counseling session. An example of the
question/answer is presented in the following pages.
The borrower will need to select the correct answer from the choices given.
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Selecting the Cancel button located at the bottom of this screen at any time during this
section will return the student to the Home Page and no information will be saved for the
Entrance Counseling portion.
The section will be once again be marked as Requires Completion and the borrower will need
to start again.
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Incorrect Response
An incorrect response to a question will result in a message at the bottom of the current page
as shown below. The user will have the opportunity to correct their response to continue the
Entrance Counseling Test further.
Your response
was incorrect.
Please try again.
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Correct Response
When the borrower has correctly responded to the question, a confirmation message will show
to validate the accuracy of the answer.
Your response to
the last question
was correct.
Please continue.
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Congratulations Page
When the borrower has correctly responded to all questions, the Entrance Counseling Test is
finally concluded and the borrower receives a Congratulations page.
Congratulations!!!
You have completed
Entrance Counseling
for you loan.
Selecting Cancel will take the borrower back to the Home Page.
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Back To Home Page
Selecting the Continue option will also take the borrower back to the Home Page where the
Entrance Counseling section will be marked as Completed.
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Loan Interview
From the Home Page, the borrower can now select the Requires Completion option located
under Loan Interview. It will take the borrower to the Loan Interview page shown below.
If the borrower chooses Continue, it will display Page One of the Loan Interview data fields.
The Loan Interview pages require the borrower to enter personal and demographic
information and is all-encompassing for the different loan types
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Selecting the Cancel button located at the bottom of this screen at any time during this
section will return the student to the Home Page and no information will be saved for the
Loan Interview portion.
The section will once again show the status Requires Completion and the borrower will need
to re-start the entire loan interview process.
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Loan Interview – Page One
Data fields included on this page:
*Major Field of Study
Name – This field cannot be updated by the borrower
SSN – This field cannot be updated by the borrower.
*Local Address – Includes Address Line 1/2, City, State, Country, 5 Digit Zip Code,
4 Digit Zip, Phone Number and Cell Phone Number
*Permanent Address (if different) Address Line 1/2, City, State, Country, 5 Digit Zip Code,
4 Digit Zip, and Phone Number
Email Address
Expected Grad Date – This field cannot be updated by the borrower
Driver’s License Number
State DL issued
Date of Birth – This field cannot be updated by the borrower
Asterisk (*) Indicates Required Field and must be populated before going to the next page.
**The Address field will present different options for Domestic and International addresses. International
address has the additional features that include City + Province/Region/ State, and International phone
numbers ranging from 10-17 characters.
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Loan Interview – Page Two
*Plans for Two Years Beyond Graduation
*Employer’s Name
*Employer’s Address, City, State, Country, Employer’s Zip, Ext. Zip
*Employer’s Phone
Borrower’s Fraternity or Sorority
Spouse’s Name
Spouse’s SSN
Spouse’s Employer Name, Address, City, State, Country, Zip Code, Ext. Zip
Spouse’s Work Phone Number
*Indicates Required Field must be populated before going to the next page. If the borrower is unemployed,
the box “I acknowledge that I do not have permanent employment established at this time” may be checked
and the Employer Information will no longer be a required field.
Selecting the Continue button will take the borrower to Page Three of the Loan Interview.
The Cancel button will take the borrower back to the Home page.
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Loan Interview – Page Three
*Father, Stepfather, Guardian, or Next of Kin Info
*Father, Stepfather, Guardian or Next of Kin Address Line 1/2, City, Province/Region/State,
Country, Zip/Postal Code, Primary Phone Number
Father, Stepfather, Guardian or Next of Kin Employer, E-mail Address
*Mother, Stepmother, Guardian, or Next of Kin Info
*Mother, Stepmother, Guardian, or Next of Kin Address Line 1/2, City, Province/Region/State,
Country, Zip/Postal Code, Primary Phone Number
Mother, Stepmother, Guardian or Next of Kin Employer, E-mail Address
*Indicates Required Field must be populated before going to the next page
Selecting the Continue button from Loan Interview Page Three will display Page Four of the
Loan Interview. The Cancel button will take the borrower back to the Home Page.
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Loan Interview – Page Four
Data fields on this page include Two References (2) from Home Locality Other than Relatives
or Students
(Reference Information)
*Name, Address Line 1/2, City, Province/Region/State, Country, Zip/Postal Code, Primary
Phone Number, E-Mail Address
Reference Employer Information - Employer Name, Address Line 1/2, City,
Province/Region/State, Country, Zip/Postal Code, 4 Digit Zip, Employer Primary Phone Number
*Indicates Required Field must be populated before going to the next page.
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Selecting the Cancel button at any time during this section will return the student to the Home
Page and no information will be saved for the Loan Interview portion.
Note: If a student selects Continue from any page of the interview section and required field(s)
have not been completed, then “This is a required field” message will be displayed immediately
below the field(s). These fields must be completed before continuing with the Loan Interview.
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Loan Interview – Page Five
Data fields on this page include Two Relatives other than Parents that will Always know your
Address
(Relative Information)
*Name, Address Line 1/2, City, Province/Region/State, Country, Zip/Postal Code, Primary
Phone Number, E-mail Address
(Relative Employer Information)
Employer Name, Address Line 1/2, City, State, Country, 5 Digit Zip Code, 4 Digit Zip, Employer
Primary Phone Number
*Indicates Required Field (must be populated before going to the next page)
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Once all the information is complete and Continue is selected, the Loan Interview- Thank You
page will be displayed.
Loan Interview-Thank You
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When Return To Home is selected, the borrower will be returned to the Home Page and the
loan interview status will show Completed.
From this page, the borrower can log out and complete the session at a later time, or choose
to move to the next step, i.e. the Master Promissory Note (MPN) option by selecting the
Requires Completion link under Master Promissory Note (MPN).
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Master Promissory Note (MPN)
The Master Promissory Note – Section One – Introduction
When the borrower selects the View Electronic Signing Document button, the following page
will be displayed.
Selecting the Cancel button will take the borrower back to the Home Page.
*After completion of the MPN, the link located under the MPN column on the Home Page will
display different statuses - Mailed, Accepted, or Declined based on the borrower’s choice.
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The Master Promissory Note – Section Two – Terms and Conditions
This page contains specific information about borrower’s rights under the E-sign act and the
consequences of e-signing a document. It also states the software required before
proceeding with the e-signature process.
The borrower must check the box ‘I consent to electronically receive important information
and conditions…’ before selecting Proceed to Master Promissory Note button which will bring
up the View PDF page.
If the Cancel button is selected, the borrower will return to the Home Page.
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The Master Promissory Note – Access PDF
This page displays a PDF image of the Master Promissory Note for the loan type indicated by
the Award File.
The Master Promissory Note opens in the same window when the borrower clicks on the
(document) image.
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MPN – View in Same Window
When the borrower hovers the mouse over the MPN image, it displays the save/ print menu.
The
(back arrow) will return the borrower to the Master Promissory Note-View PDF page.
NOTE: For non-Perkins loans, either a single or multi-year note will be displayed according to
the borrower record submitted on the Award File. Single year notes for non-Perkins loans
display a Schedule of Advances chart pre-filled from information contained in the Award File.
Federal Perkins MPN’s do not have a Schedule of Advances for single-year note. The single
or multi-year field on the Award File determines whether or not a note is displayed on the
Home Page.
Examples of Master Promissory Notes for each loan type are located in the Appendix section
of this document.
In order to E-sign or mail this document, the borrower must check the box beginning ‘I
acknowledge that I have read the terms and conditions…” as seen on the previous page
following which the two buttons, Sign Electronically and Sign By Mail will become available
at this time.
When the Sign By Mail button is selected, the following page will be displayed.
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The Master Promissory Note – Sign By Mail
The borrower can indicate a different mailing address for the Master Promissory Note than
the one displayed by unchecking Mail to above address box. The address lines will be
enabled for the borrower to enter the address.
When Submit is chosen, the following page will be displayed.
Note: Using the Mail option for the MPN will automatically update the TLID to be mailed
also.
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The Return to Home button will take the borrower back to the Home Page. The Master
Promissory Note and Total Loan Indebtedness Disclosure columns of the Home Page will now
indicate Mailed status.
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MPN - View MPN
The borrower can also select the MPN link labeled as Mailed (on the Home Page) in order to
view the document after completion. The borrower must select the checkbox “I consent to
electronically receive important information…” move to the MPN page.
To view the MPN, it is not required to check the box ‘I acknowledge that I have read the terms
and conditions of the Master Promissory Note (MPN).’
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Click on the image to view the MPN document. Select Open with or Save File message window
and press OK.
The PDF document will open in a separate browser window. Once opened and/or saved on
the borrower’s desktop operating system/device, the MPN can be printed. Choose File from
the toolbar located at the top of the screen and select Print.
Once the borrower has completed the printing or viewing process, he/she may return to the
Home Page by closing the window.
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The Master Promissory Note - Sign Electronically
The borrower can also choose to electronically sign the document by selecting the button Sign Electronically. Check on the box “I acknowledge…” before selecting the Sign Electronically option.
The borrower must accept the award by selecting the I Accept the Award As Shown button and
the Student Authentication Network (STAN) Page will be displayed.
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STAN Authentication
If the borrower selects the Submit button, it will open the Student Authentication Network
Page, an external site where the e-signature authentication process will commence.
Subsequently, he/she will be returned to the iPROMise site for confirmation of signature.
The Cancel button will take the user back to the Home Page.
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On this page, the borrower enters his social security number, first two characters of his last
name, date of birth, and his or her PIN number to confirm his/her identity.
The borrower must take care to enter the correct information. The Submit button will display a
security warning in case the information is incorrect.
Reset will clear the page so that all the information can be re-entered.
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E-Signature
The e-signature will be located in the bottom left corner of the first page for a Federal Perkins
loan and on the last page of the MPN for a non-Perkins loan. See picture below for an
example:
Tony Bashman
Borrower’s Signature
2016-06-30-10.27.47.592000
Date
Authentication Code: 200302236BA197012110350
E-Signature consists of:
•
•
•
•
The borrower’s name.
The date the signature was applied.
A timestamp.
Authentication Code – A number comprised of the borrower’s SSN, first two letters of
last name, DOB, and a Verification Acknowledgement Sequence (VAS – a 4 digit
number assigned by the STAN site).
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Successful STAN Authentication
The following page is displayed when the borrower’s identity is successfully validated. The
borrower now has the option to apply the electronic signature to the MPN by selecting the
Confirm Signature button.
The
(back arrow) will return the borrower to the beginning of Section 4 where he/she can
accept or decline the award.
If the borrower selects the Confirm Signature button, the electronic signature is applied and
the borrower will receive a confirmation in form of a Thank you message.
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Confirmed Signature
The borrower will receive conformation of his/her e-signing the MPN document in the form of
a Thank You message.
The status of the MPN on the Home Page will change to E-Signed.
Note: E-Signing the MPN does not change the status of the TLID. After returning to the Home
Page, the borrower must select the TLID link to view, accept, mail, or decline the TLID.
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If the borrower selects the I Decline the Award button, a window will pop up asking the
borrower if he/she has declined the award and that his/her school needs to be notified. The
message “Are you sure…?” will appear on the screen. The borrower can choose to confirm or
cancel the message.
Once I Decline the Award option is chosen, the Borrower cannot make any changes to the
iPROMise site. The user will then need to contact the school’s student loan administrator or
Campus Partners’ Client Relations Representative.
Note: By declining the MPN, the TLID is automatically declined as well. The Home Page will
show both columns as declined and the borrower will be unable to view the documents.
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Selecting Cancel button will bring the borrower back to the Home Page.
The Home page will show the following message.
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E-Signed MPN Display
Once the MPN is electronically signed, the MPN status becomes a link that will allow the user
to view and print the e-signed MPN. To view the e-signed MPN, the borrower should choose
the E-Signed link on the Home Page.
The MPN will open in a new browser window once the borrower chooses to Open with Adobe
Acrobat. Once opened, the borrower can choose to Save or Print the PDF document.
Once the MPN process has concluded, the borrower may return to the Home Page to
complete the TLID process.
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Total Loan Indebtedness Disclosure (TLID)
If the borrower has already signed the MPN or does not have an MPN to sign, the link for the
TLID will show Requires Completion. To view, accept or decline the TLID, the borrower should
click the Requires Completion link. To view the TLID, the borrower must click the box ‘I
consent to electronically receive important information…’ Then the borrower must click on
the document image to open the window with the TLIP PDF.
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View TLID Page in a Separate Window
Once the borrower chooses Open with Adobe Acrobat option and select OK, the PDF
document will open in a new browser window and the borrower will see the following page:
The borrower can now choose to save the PDF on his or her desktop.
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The PDF will allow the borrower to download and save the document. Check the box ‘I
acknowledge that I have read the terms and conditions of the Disclosure and would like to:’
Now the borrower can accept or decline the award or request a copy to be mailed.
If Accept the award as shown is selected, a Confirmation page will be displayed:
Thank You Page – Accepted TLID
The Return To Home button will return the borrower to the Home Page where counseling can
continue for other loans or the borrower can log out of the site.
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If the borrower chooses to Decline the award, the message box “Are you sure you want to..?” will
appear. The borrower can choose to Cancel or Confirm the message.
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When the borrower checks the box, Have a copy of the Total Loan Indebtedness Disclosure
mailed to me, the following page will be displayed:
The borrower can indicate (if he chooses) a different address for mailing the TLID to other
than the one displayed by un-checking Mail to above address box. The address lines will be
enabled for the borrower to enter the new address.
Selecting the Submit button will display the Thank you Page.
*The link located under the TLID column on the Home Page can display different statuses
(Mailed, Accepted, or Declined. Since some of these statuses are dependent on the action
taken on the MPN, this section describes the borrower experience based on the different
status possibilities for TLID.
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About The Total Loan Indebtedness Disclosure
The Total Loan Indebtedness Disclosure is a statement that represents the total award
amount given to a borrower. The TLID presented to the borrower is based on the loan type as
submitted on the Award File. All fields that can exist on a TLID are listed below. The loan type
that the field pertains to is listed beside the field. If the field does not specify which loan type,
then it applies to a Perkins/INST loan Total Loan Indebtedness Disclosure unless otherwise
noted.
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School Name*
Award Year*
Student/Maker*
Borrower Name* (HPSL, PCL, LDS, NSL)
University Campus Name* (HPSL, PCL, LDS, NSL)
Account Number – Will be filled if loans exist on System III (HPSL, PCL, LDS, and NSL)
Student Address*
Student Email Address*
Creditor/Lender*
SSN*
Student ID
Estimated Separation Date* (All Loan Types)
Campus Address
Annual Percentage Rate*
Cumulative Amount Financed (Previous loan information in this column comes from
System III – All Loan types)
Current Loan Balance (Previous loan information in this column comes from System III –
All Loan Types
Total All Loans (Total of all loans – current and previous – All Loan Types).
Number of Payments – Filled if borrower has System III loans. (HPSL, PCL, LDS, NSL)
Amount of Payments – Filled if borrower has System III loans. (HPSL, PCL, LDS, NSL)
Interest Accrues Beginning - Filled if borrower has System III loans. (HPSL, PCL, LDS,
NSL)
First Payment Due – Filled if borrower has System III loans. (HPSL, PCL, LDS, NSL)
Frequency of Payments – Filled if borrower has System III loans. (HPSL, PCL, LDS, NSL)
*Pre-filled from the Award File
The information contained within the document will vary based on loan type, but in general,
contains information regarding the terms and obligations of a student loan and the possible
consequences of default. Examples of each Total Loan Indebtedness Disclosure can be
found in the Appendix section of this document.
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Cancelled Awards
If a borrower’s school cancels an award, the borrower will still be able to login to the site;
however, the word Cancelled will be displayed for each section. The Home Page for a
borrower with a cancelled award is shown below.
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Deleted Awards
Registered Borrower/Single Award
If a borrower has previously registered on the site and the school deletes an award for a
borrower, the following message will be displayed on the Log in page when a login is
attempted:
Previous records for this user name have been deleted or account is inactive. Please contact
your school for information regarding your award status.
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Unregistered Borrower/Single Award
If a borrower’s school deletes the only award for a borrower and the borrower has not
previously registered on the site, the following message will be displayed on the login page
when login is attempted.
An active student record does not exist. Please verify the information that you are providing
with your school.
In case of Multiple Awards, if the school deletes only one of the borrower’s awards, then the
normal login process will occur.
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iPROMise Login
The borrower will use the User Name and Password created at registration to:
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Log-in to iPROMise
Complete their Entrance Counseling Test and Loan Interview
Sign the Master Promissory Note (MPN)
View/print the MPN and Truth-in-Lending Disclosure (TLID) document
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Invalid Login Message
If the User Name or Password entered is invalid, then the following message will be displayed:
The user id and/or password in incorrect or your school status is inactive. Please contact
your school.
The borrower should re-enter their User name and/or Password and try again. If he/she has
forgotten either the User name or Password, then he/she should click the Get My User
ID/Password link.
Selecting the Exit button from this page will return the borrower to the Home page.
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Get My User ID/Password
The Get My User ID/Password option allows the borrower who has forgotten either required
element to obtain both the ID and Password by providing the same identifier information as
they originally supplied when registering for iPROMise.
If incorrect information is entered, the message, “Student record not found. Please try again”
will be displayed.
Selecting the Cancel button will return the borrower to the Welcome page. The borrower will
be given another chance to enter the correct information.
Once the correct information is provided and the Submit button is selected, the borrower will
be presented with the Retrieve User ID/Password Screen.
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Retrieve ID and Password-Security Question
The borrower will be asked to answer a security question selected during the registration
process. The borrower should enter the answer to this question in the space provided. The
borrower must enter the correct answer to his/her question in order to receive his/her User
ID and password.
The borrower should contact Campus Partners to obtain forgotten answers to security
questions.
If the Cancel button is selected, the borrower will be returned to the Welcome Page.
Selecting the Submit button will display the following page:
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This page will retrieve the User ID and the password to the borrower.
If Go To Login is selected, the borrower will be required to re-enter his/her password only;
the User ID is already pre-filled.
If the Exit button is selected, the site will return the borrower to the Welcome page.
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Appendix
1. Federal Perkins Award File Data Fields
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
Student Notification Flag–Required field. Values = E (email), L (letter), N (none), B (both
email and letter)
Borrower Flag–Required field. Values = N (new borrower at your institution), R (repeat
borrower at your institution).
MPN Type Indicator–Required field. Values = S (single year), M (multi-year), C (multiyear signed)
Borrower Name–Required field. Must be last name, comma, space, first name, space,
middle initial (ex: Doe, Joe F).
Borrower Address Line 1–Required field.
Borrower Address Line 2–May be used for additional address information, if needed.
May be left blank.
Borrower City–Required field
Borrower State–Required field
Borrower Zip–Required field. If populated with numeric value, first 5 positions are
required; last 4 positions are optional.
Foreign Address – Include City+ Province/ Region/ State – Required Field
Foreign Zip/Postal Code
Borrower Telephone–Optional
Borrower International Phone Number – Ranges from 10-17 characters
Driver’s License Number–Optional
State DL Issued–Optional
SSN - Required field
Email Address–Optional
Date of Birth–Required field. Format: YYYYMMDD (year, month, day)
System III Program Number–Required field
Loan Type–Required field. Values = N (Federal Perkins), H (HPSL), T NSL, L (LDS), P
(PCL), I (INST)
Note Type–Required field: Values: D (single borrower note).
*Additional note types will be added for additional loan types at a later date.
Fund Number–Optional
Interest Rate–Required field. Percentage format (ex. 5% = 05000).
Grace Months–Required field
Award Amount Fall–Required field. Can be zero filled.
Award Amount Winter–Required field. Can be zero filled.
Award Amount Spring–Required field. Can be zero filled.
Estimated Separation Date–Required field. Format YYYYMMDD (year, month, day).
Cannot be greater than 10 years from the award date.
University Campus Name–Required field.
First 3 letters of Borrower’s Last Name–Required field.
Award Amount Summer–Required field. Can be zero filled.
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32. Award Year–Required field. The award year is the start year of the school’s academic
year (2014/2015 - fall, winter, spring, and summer). For example, an award for spring
of 2015 is in the 2014 award year.
33. Record Type–This flag identifies the record type. Values are: Blank or N = Newly
reported award.
**Additional values will be added at a later date.
34. School Entrance Date-Required field. Format YYYYMMDD. This date should be the date
that the borrower entered school. It is used on non-Perkins MPNs.
35. Fall Award Date-Required field if MPN Indicator = S and a Fall Award amount is
entered. Format YYYYMMDD.
36. Winter Award Date-Required field if MPN Indicator = S and a Winter Award amount is
37. Spring Award Date-Required field if MPN Indicator = S and a Spring Award amount is
38. Summer Award Date-Required field if MNP Indicator = S and a Summer Award amount
is entered. Format YYYYMMDD.
Please note that this is only the data contained in the award file and not the actual layout.
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2. Borrower Notification Email
Date: 04/12/2015 09:32:43 AM EST
Subject: Your <<loan type>> Loan
Dear Borrower:
Campus Partners has been notified of your <<loan type>>Loan award by (university name).
Before (university name) can disburse the loan, you must complete Federal Entrance Counseling
and a Loan Interview Questionnaire and sign your Master Promissory Note (MPN).
Campus Partners is pleased to make this process available to you as a convenient on-line
service. To begin your session, please visit us at http://ipromise.campuspartners.com. By
following the directions on this Web site, you will be able to become a registered user of our site
and complete your Entrance Counseling session, your loan interview, and MPN. You can even
e-sign your MPN using your FSA pin. If you have forgotten your FSA pin, you may access the
federal student aid Web site at www.pin.ed.gov to obtain a duplicate pin number.
If you do not have access to our on-line service, please contact (your university) to set up an
appointment to complete the <<loan type>> Entrance Counseling session, your Loan Interview,
and your Master Promissory Note (MPN).
Congratulations on your <<loan type>> loan award and best of luck in your studies.
Sincerely,
Campus Partners
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3. HPSL/LDS Multi-Year MPN
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS)
PUBLIC HEALTH SERVICE (PHS)
HEALTH RESOURCES AND SERVICES ADMINISTRATION
BUREAU OF HEALTH PROFESSIONS GUIDANCE
<<PROGRAM NAME>>
MASTER PROMISSORY NOTE
MULTIPLE YEAR
FOR LOANS MADE ON OR AFTER
NOVEMBER 13, 1998
I, <<First name >><<Last name>> , hereinafter called the Borrower, promise to pay to <<Institution Name>>,
hereinafter called the Institution located at <<School City>> << School State>> , the sum of such amounts as may
from time to time be advanced to me with interest at the rate of Five (5) percent per annum together with all
attorney's fees, collection agent costs, and other related costs and charges for the collection of any amount not paid
when in default according to the terms of this Promissory note.
The Borrower and Institution further understand and agree that:
1. Consolidation (42 CFR 57.208): If the Institution makes more than one loan, with the same repayment terms, to
the Borrower under the <<Program Name>> program, the sum of the amounts advanced to the Borrower shall
be consolidated for purposes of repayment. Each payment made by the Borrower to the Institution shall be
applied first to interest which has accrued on the unpaid principal balance and then to the principal sum of the
total loan.
2. Repayment (Section 722 Public Health Service Act, 42 CFR 57.210):
a. Repayment shall be made in equal or graduated periodic installments within the repayment period, except that
the Institution may require repayment to be made in an amount equal to not less than $40 per month. The
repayment period begins one year after the Borrower ceases to be a fulltime student at a school eligible to
participate in the <<Program Name>> program. The repayment period shall not be less than ten years, nor more
than 25 years, at the discretion of the Institution. Periods of authorized deferment are not included as part of the
repayment period.
b. The terms and conditions of repayment shall be set forth in a separate repayment period schedule which is
approved by the Institution and agreed to by the Borrower. Payments under the repayment schedule shall be
made to the Institution or its representative no less often than quarterly, except that if the Borrower is more than
60 days past due on a payment, the remaining balance of the loan shall be repaid on a monthly basis.
3.
Interest (Section 722 Public Health Service Act, 42 CFR 57.208): Interest shall accrue from the beginning of
the repayment period.
4.
Deferment (Section 722 Public Health Service Act, 42 CFR 57.210): Periodic installments of principal and
interest need not be paid, and interest shall not accrue, while the Borrower: (a) serves on active duty as a
member of a uniformed service of the United States, for up to three years; (b) serves as a volunteer under the
Peace Corps Act, for up to three years; (c) pursues advanced professional training, including internships and
residencies; (d) pursues a full-time course of study at a health professions school eligible for participation in the
<<Program Name>> program; (e) leaves the Institution, with the intent to return to the Institution as a fulltime student, to engage in a full-time educational activity which is directly related to the health profession for
which the Borrower is preparing, as determined by the Secretary of Health and Human Services (the Secretary),
for up to two years; and (f) participates in a fellowship training program or a full-time educational activity
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which is directly related to the health profession for which the Borrower prepared at the Institution, and is
engaged in by the Borrower within 12 months after the completion of the Borrower's participation in advanced
professional training (described in 4(c) above) or prior to the completion of the Borrower's participation in such
training, for up to two years.
5.
Prepayment (Section 722 Public Health Service Act): The Borrower may, at his or her option and without
penalty, prepay all or any part of the principal and accrued interest at any time.
6.
Exit Interview (42 CFR 57.210): The Borrower agrees to attend an exit interview prior to completing or
terminating full-time student status at the Institution.
7.
Default (42 CFR 57.208): If the Borrower fails to make an installment payment when due or fails to comply
with any other term of this Promissory Note, the loan will be considered in default.
8.
Late Charge (Section 721 Public Health Service Act, 42 CFR 57.210): The Institution shall assess a late
penalty charge for failure of the Borrower to pay all or any part of an installment, or for failure to file
satisfactory evidence of entitlement to deferment, if so entitled, at a rate, not to exceed an amount equal to 6
percent as determined by the Institution of the amount of such installment, on loans more than 60 days past due.
9.
Acceleration (42 CFR 57.208): If the Borrower fails to make a scheduled repayment or fails to comply with any
other term of this Promissory Note, the entire unpaid balance of the loan, including interest due and accrued and
any applicable penalty charges, will, at the option of the Institution, become immediately due and payable.
10. Credit Bureaus (42 CFR 57.210): The Institution may disclose the Borrower's loan, and any other relevant
information, to credit bureaus. If the Borrower is more than 120 days past due in making a scheduled
repayment, the Institution will disclose the Borrower's delinquent status, and any other relevant information, to
credit bureaus.
11. Collection Agents, Litigation, and Withholding of Services (Section 722 Public Health Service Act, 42
CFR 57.210): If the Borrower fails to make a scheduled repayment, or fails to comply with any other term o f
this Promissory Note, the Institution may: (a) refer the Borrower's loan to a collection agent for further collection
efforts; (b) initiate legal proceedings against the Borrower; (c) withhold Institutional services, such as transcripts
and letters of recommendation, from the Borrower; <<Program Name>> Program (d) refer the Borrower's loan
to the Secretary for collection assistance, including offset of Federal salaries; and (e) obtain the Borrower's
address from the Internal Revenue Service through the Secretary, if the Institution has no current address for the
Borrower.
12. Death or Disability (42 CFR 57.211): In the event of the Borrower's total and permanent disability or death, the
unpaid indebtedness remaining on the Promissory Note shall be canceled. Subject to the regulations of the
Secretary, the Institution may assess a charge on the Borrower's loan to cover the costs of insuring against death
or disability cancellations.
13. General: The Borrower will promptly inform the Institution of any change in name or address after he or she
ceases to be a full-time student at the Institution. The terms of this Promissory Note shall be construed according
to the Federal statute and regulations governing the administration of the<<Program Name>>, copies of which
shall be kept by the Institution
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Notice About Subsequent Loans Made Under This Master Promissory Note
This Note authorizes the Institution to disburse multiple loans during the multi-year term of this Note upon the
Borrower's request and upon the Institution's determination of the Borrower's loan eligibility. Subsequent loans
may be made under the Note for the same or subsequent periods of enrollment at this Institution. The Institution
however, may at its discretion, close this Note at any time and require the Borrower to sign a new Note for
additional disbursements. If the Institution chooses to make subsequent loans under this Note, no such loans will
be made after the earliest of the following dates: (i) the date this Institution receives the Borrower's written notice
that no further loans may be made disbursed under this note; (ii) the date of withdrawal from the Institution by the
Borrower. Any amendments to the Public Health Service Act governs the terms of any loans disbursed on or after
the effective date of such amendment, and such amended terms are hereby incorporated into this Note.
NOTICE: The Institution must require security or endorsement if the Borrower is a minor and if, under the
applicable State law, the Note signed by him or her would not create a binding obligation. The Institution may not
require security or endorsement in any other circumstances. The Institution shall supply a copy of this Note to the
Borrower.
WARNING: Any person who knowingly makes a false statement or misrepresentation in obtaining these funds is
subject to penalties which may include fines and imprisonment under Federal statute.
I agree to the terms and conditions of this Promissory Note.
I accept use of this as my Master Promissory Note for all loans received under the <<Program Name>>
(Program name initials) program.
Date
Borrower Name
Address1
Address2
City State Zip
Social Security Number
Date of Birth
School Entrance Date
School Exit Date
Borrower Signature
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4. HPSL/LDS Single Year MPN
BUREAU OF HEALTH PROFESSIONS GUIDANCE
<<PROGRAM NAME>>
MASTER PROMISSORY NOTE
SINGLE YEAR
NOVEMBER 13, 1998
I, <<First name >><<Last name>> , hereinafter called the Borrower, promise to pay to <<Institution Name>>,
hereinafter called the Institution located at <<City>> <<State>> , the sum of such amounts as may from time to time
be advanced to me and endorsed in the Schedule of Advances below with interest at the rate of Five (5) percent per
annum together with all attorney's fees, collection agent costs, and other related costs and charges for the collection
of any amount not paid when in default according to the terms of this Promissory note.
SCHEDULE OF ADVANCES
Number
Amount Advanced
Total
To Date
the Borrower under the <<Program Name>> program, the sum of the amounts advanced to the Borrower shall be
consolidated for purposes of repayment. Each payment made by the Borrower to the Institution shall be applied first
to interest which has accrued on the unpaid principal balance and then to the principal sum of the total loan.
a. Repayment shall be made in equal or graduated periodic installments within the repayment period, except that the
Institution may require repayment to be made in an amount equal to not less than $40 per month. The repayment
period begins one year after the Borrower ceases to be a fulltime student at a school eligible to participate in the
<<Program Name>> program. The repayment period shall not be less than ten years, nor more than 25 years, at the
discretion of the Institution. Periods of authorized deferment are not included as part of the repayment period.
b. The terms and conditions of repayment shall be set forth in a separate repayment period schedule which is
approved by the Institution and agreed to by the Borrower. Payments under the repayment schedule shall be made to
the Institution or its representative no less often than quarterly, except that if the Borrower is more than 60 days past
due on a payment, the remaining balance of the loan shall be repaid on a monthly basis.
3. Interest (Section 722 Public Health Service Act, 42 CFR 57.208): Interest shall accrue from the beginning of
the repayment period.
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4. Deferment (Section 722 Public Health Service Act, 42 CFR 57.210): Periodic installments of principal and
interest need not be paid, and interest shall not accrue, while the Borrower: (a) serves on active duty as a member of
a uniformed service of the United States, for up to three years; (b) serves as a volunteer under the Peace Corps Act,
for up to three years; (c) pursues advanced professional training, including internships and residencies; (d) pursues a
full-time course of study at a health professions school eligible for participation in the <<Program Name>>
program; (e) leaves the Institution, with the intent to return to the Institution as a full-time student, to engage in a
full-time educational activity which is directly related to the health profession for which the Borrower is preparing,
as determined by the Secretary of Health and Human Services (the Secretary), for up to two years; and (f)
participates in a fellowship training program or a full-time educational activity which is directly related to the health
profession for which the Borrower prepared at the Institution, and is engaged in by the Borrower within 12 months
after the completion of the Borrower's participation in advanced professional training (described in 4(c) above) or
prior to the completion of the Borrower's participation in such training, for up to two years.
5. Prepayment (Section 722 Public Health Service Act): The Borrower may, at his or her option and without
6. Exit Interview (42 CFR 57.210): The Borrower agrees to attend an exit interview prior to completing or
7. Default (42 CFR 57.208): If the Borrower fails to make an installment payment when due or fails to comply with
any other term of this Promissory Note, the loan will be considered in default.
8. Late Charge (Section 721 Public Health Service Act, 42 CFR 57.210): The Institution shall assess a late
penalty charge for failure of the Borrower to pay all or any part of an installment, or for failure to file satisfactory
evidence of entitlement to deferment, if so entitled, at a rate, not to exceed an amount equal to 6 percent as
determined by the Institution of the amount of such installment, on loans more than 60 days past due.
9. Acceleration (42 CFR 57.208): If the Borrower fails to make a scheduled repayment or fails to comply with any
other term of this Promissory Note, the entire unpaid balance of the loan, including interest due and accrued and any
applicable penalty charges, will, at the option of the Institution, become immediately due and payable.
information, to credit bureaus. If the Borrower is more than 120 days past due in making a scheduled repayment, the
Institution will disclose the Borrower's delinquent status, and any other relevant information, to credit bureaus.
11. Collection Agents, Litigation, and Withholding of Services (Section 722 Public Health Service
Act, 42 CFR 57.210): If the Borrower fails to make a scheduled repayment, or fails to comply with any other term
of this Promissory Note, the Institution may: (a) refer the Borrower's loan to a collection agent for further collection
efforts; (b) initiate legal proceedings against the Borrower; (c) withhold Institutional services, such as transcripts and
letters of recommendation, from the Borrower; <<Program Name>> Program (d) refer the Borrower's loan to the
Secretary for collection assistance, including offset of Federal salaries; and (e) obtain the Borrower's address from
the Internal Revenue Service through the Secretary, if the Institution has no current address for the Borrower.
unpaid indebtedness remaining on the Promissory Note shall be canceled. Subject to the regulations of the Secretary,
the Institution may assess a charge on the Borrower's loan to cover the costs of insuring against death or disability
cancellations.
ceases to be a full-time student at the Institution. The terms of this Promissory Note shall be construed according to
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the Federal statute and regulations governing the administration of the <<Program Name>>, copies of which shall
be kept by the Institution.
Notice About Subsequent Loans Made Under This Master Promissory Note This Note authorizes the
Institution to disburse multiple loans during the multi-year term of this Note upon the Borrower's request and
upon the Institution's determination of the Borrower's loan eligibility. Subsequent loans may be made under the
Note for the same or subsequent periods of enrollment at this Institution. The Institution however, may at its
discretion, close this Note at any time and require the Borrower to sign a new Note for additional disbursements.
If the Institution chooses to make subsequent loans under this Note, no such loans will be made after the earliest
of the following dates: (i) the date this Institution receives the Borrower's written notice that no further loans may
be made disbursed under this note; (ii) the date of withdrawal from the Institution by the Borrower. Any
amendments to the Public Health Service Act governs the terms of any loans disbursed on or after the effective
date of such amendment, and such amended terms are hereby incorporated into this Note.
Borrower.
I accept use of this as my Master Promissory Note for all loans received under the <<Program Name>>
(Program name initials) program.
Date
Borrower Name
Address1
Address2
City State Zip
Date of Birth
School Exit Date
Borrower Signature
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5. Institutional Multi-Year
<<University Campus Name>>
Multiple Year Master Promissory Note
Section A: Borrower Section
Last Name, First Name, MI
Address 1
Address 2
City
St
Date of Birth
Zip
Phone Number ( )
Section B: School Section
University Campus Name
Address 1
Address 2
City
St
Zip
Annual Interest Rate:
Repayment Frequency:
Term:
Terms and Conditions:
Educational Loan – This institutional loan is made for educational purposes and I understand and acknowledge that
this loan will be used for educational purposes. I understand that I may increase my loan obligation if I qualify for
additional funds as specified by my lender. Subsequent loans shall increase the amount I must pay, the repayment
schedule, minimum term and total finance charges.
Interest – Interest accrues on the unpaid principal balance from the beginning of the repayment term and accrues at
the Annual Interest Rate as shown in Section B of this document.
Other Fees and Charges – Late charges will be imposed on scheduled payments that are not received by the due
date.
Repayment Term – I am obligated to repay the principal and interest that accrues on my loan(s) to my lender
beginning <<grace months>>months after the date that I cease to be a student at <<Lender Name>> and ending
<<term>> months (Section B) later unless I request in writing that my repayment period end sooner. I will make
installment payments based on the Repayment Frequency stated above in Section B of this document or as
otherwise stated by <<Lender Name>>.
Default – My lender at its option may declare my loan to be in default, if I fail to comply with the terms and conditions
as specified in this Promissory Note or repayment agreement. I may also be subject to losing the right to defer
payments or the right to deferment of this loan (if such provisions exist for this loan). The lender may accelerate my
defaulted loan. Acceleration means that the lender demands immediate payment of the entire unpaid balance of the
loan, including principal, interest, late charges, and collection costs.
Billing – I understand that during repayment periods, I will receive a billing statement at the address I provide to
<<Lender Name>>, unless I select another method of billing. It is my responsibility to inform my lender or its billing
agent of any change in my name, address, or telephone number.
Grace Period – I will receive an initial grace period before the first payment is due. Interest does not accrue during
the initial grace period.
Promise To Pay – I promise to pay <<Lender Name>> or a subsequent holder of this Promissory Note the sum of
the amount(s) advanced to me under the Terms of this note, plus interest and other fees which become due as
provided by this Note. I promise to pay all reasonable collection costs, including attorney’s fees and other charges
necessary for the collection of any amount not paid when due. My signature certifies that I have read, understand,
and agree to the terms and conditions of this Promissory Note.
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I UNDERSTAND THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS
PROMISSORY NOTE AND THAT I MUST REPAY SUCH LOANS.
I accept use of this as my Master Promissory Note for all loans received under the <<Program Name>> program.
Borrower’s Signature_
Date
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6. Institutional Single Year
Multiple Year Master Promissory Note
Last Name, First Name, MI
Address 1
Address 2
City
St
Date of Birth
Zip
Phone Number ( )
University Campus Name
Address 1
Address 2
City
St
Annual Interest Rate:
Repayment Frequency:
Term:
Zip
Number
Amount Advanced
Total
To Date
Terms and Conditions:
Educational Loan – This institutional loan is made for educational purposes and I understand and acknowledge that
this loan will be used for educational purposes. I understand that I may increase my loan obligation if I qualify for
additional funds as specified by my lender. Subsequent loans shall increase the amount I must pay, the repayment
schedule, minimum term and total finance charges.
Interest – Interest accrues on the unpaid principal balance from the beginning of the repayment term and accrues at
the Annual Interest Rate as shown in Section B of this document.
Other Fees and Charges – Late charges will be imposed on scheduled payments that are not received by the due
date.
Repayment Term – I am obligated to repay the principal and interest that accrues on my loan(s) to my lender
beginning <<grace months>>months after the date that I cease to be a student at <<Lender Name>> and ending
<<term>> months (Section B) later unless I request in writing that my repayment period end sooner. I will make
installment payments based on the Repayment Frequency stated above in Section B of this document or as
otherwise stated by <<Lender Name>>.
Default – My lender at its option may declare my loan to be in default, if I fail to comply with the terms and conditions
as specified in this Promissory Note or repayment agreement. I may also be subject to losing the right to defer
payments or the right to deferment of this loan (if such provisions exist for this loan). The lender may accelerate my
defaulted loan. Acceleration means that the lender demands immediate payment of the entire unpaid balance of the
loan, including principal, interest, late charges, and collection costs.
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Billing – I understand that during repayment periods, I will receive a billing statement at the address I provide to
<<Lender Name>>, unless I select another method of billing. It is my responsibility to inform my lender or its billing
agent of any change in my name, address, or telephone number.
Grace Period – I will receive an initial grace period before the first payment is due. Interest does not accrue during
the initial grace period.
Promise To Pay – I promise to pay <<Lender Name>> or a subsequent holder of this Promissory Note the sum of
the amount(s) advanced to me under the Terms of this note, plus interest and other fees which become due as
provided by this Note. I promise to pay all reasonable collection costs, including attorney’s fees and other charges
necessary for the collection of any amount not paid when due. My signature certifies that I have read, understand,
and agree to the terms and conditions of this Promissory Note.
I UNDERSTAND THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS
PROMISSORY NOTE AND THAT I MUST REPAY SUCH LOANS.
I accept use of this as my Master Promissory Note for all loans received under the <<Program Name>> program.
Borrower’s Signature_
Date
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7. NSL Multi-Year
BUREAU OF HEALTH PROFESSIONS
GUIDANCE
NURSING STUDENT LOAN PROGRAM
MASTER PROMISSORY NOTE MULTIYEAR
NOVEMBER 13, 1998
I, <<First name>><<M.I.) (Last name), hereinafter called the Borrower, promise to pay to Institution Name),
hereinafter called the Institution located at (City) (State) , the sum of such amounts as may from time to time be
advanced to me with interest at the rate of Five (5) percent per annum together with all attorney's fees, collection agent
costs, and other related costs and charges for the collection of any amount not paid when in default according to the
terms of this Promissory Note.
the Borrower under the Nursing Student Loan program, the sum of the amounts advanced to the Borrower shall be
consolidated for purposes of repayment. Each payment made by the Borrower to the Institution shall be applied first to
interest which has accrued on the unpaid principal balance and then to the principal sum of the total loan.
a. Repayment shall be made in equal or graduated periodic installments within a ten-year repayment period, except
that the Institution may require repayment to be made in an amount equal to not less than $40 per month. The ten year
repayment period begins nine months after the Borrower ceases to be a full-time or half-time student (as defined by
the institution) at a school eligible to participate in the Nursing Student Loan program. Periods of authorized
deferment are not included as part of the ten year repayment period.
b. The terms and conditions of repayment shall be set forth in a separate repayment period schedule which is approved
by the Institution and agreed to by the Borrower. Payments under the repayment schedule shall be made to the
Institution or its representative no less often than quarterly, except that if the Borrower is more than 60 days past due
on a payment, the remaining balance of the loan shall be repaid on a monthly basis.
3. Interest (Section 836 Public Health Service Act, 42 CFR 57.310): Interest shall accrue from the beginning of the
repayment period.
interest need not be paid, and interest shall not accrue, while the Borrower: (a) serves on active duty as a member of a
uniformed service of the United States, for up to three years; (b) serves as a volunteer under the Peace Corps Act, for
up to three years; and (c) pursues, for up to ten years, a fulltime or half-time course of study at a collegiate school of
nursing leading to a baccalaureate degree in nursing or equivalent degree, or a graduate degree in nursing, or otherwise
pursues advanced professional training in nursing or training to be a nurse anesthetist. Advanced professional training
shall include full-time or half-time training, beyond the first diploma or degree in nursing received by the particular
borrower, of at least 1 academic year which will advance the borrower's knowledge of and strengthen his or her skills
in the provision of nursing services.
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5. Prepayment (42 CFR 57.310): The Borrower may, at his or her option and without penalty, prepay all or any part
of the principal and accrued interest at any time.
terminating full or half-time student status at the Institution.
7. Default (Section 835 Public Health Service Act, 42 CFR 57.302): If the Borrower fails to make an installment
payment when due or fails to comply with any other term of this Promissory Note, the loan will be considered in
default.
8. Late Charge (Section 836 Public Health Service Act, 42 CFR 57.310): The Institution shall assess a late penalty
charge for failure of the Borrower to pay all or any part of an installment, or for failure to file satisfactory evidence of
entitlement to deferment, if so entitled, at a rate, not to exceed an amount equal to 6 percent, as determined by the
Institution, of the amount of such installment, on loans more than 60 days past due.
other terms of this Promissory Note, the entire unpaid balance of the loan, including interest due and accrued and any
Institution will disclose the Borrower's delinquent status and any other relevant information to credit bureaus.
11. Collection Agents, Litigation, and Withholding of Services (42 CFR 57.310): If the Borrower fails to make a
scheduled repayment, or fails to comply with any other term of this Promissory Note, the Institution may: (a) refer the
Borrower's loan to a collection agent for further collection efforts; (b) initiate legal proceedings against the Borrower;
(c) withhold Institutional services, such as transcripts and letters of recommendation, from the Borrower; (d) refer the
Borrower's loan to the Secretary of the U.S. Department of Health and Human Services (DHHS) for collection
assistance, including offset of Federal salaries; and (e) obtain the Borrower's address from the Internal Revenue
Service, through the Secretary of DHHS, if the Institution has no current address for the Borrower.
12. Death or Disability (Section 836 Public Health Service Act, 42 CFR 57.311): In the event of the Borrower's
total and permanent disability or death, the unpaid indebtedness remaining on the Promissory Note shall be canceled.
ceases to be a full-time student or half-time student at the Institution. The terms of this Promissory Note shall be
construed according to the Federal statute and regulations governing the administration of the Nursing Student Loan
program, copies of which shall be kept by the Institution.
Notice About Subsequent Loans Made Under This Master Promissory Note This Note authorizes the
Institution to disburse multiple loans during the multi-year term of this Note upon the Borrower's request and
upon the Institution's determination of the Borrower's loan eligibility. Subsequent loans may be made under the
Note for the same or subsequent periods of enrollment at this Institution. The Institution ho wever, may at its
discretion, close this Note at any time and require the Borrower to sign a new Note for additional disbursements.
If the Institution chooses to make subsequent loans under this Note, no such loans will be made after the earliest
of the following dates: (i) the date this Institution receives the Borrower's written notice that no further loans
may be made disbursed under this note; (ii) the date of withdrawal from the Institution by the Borrower. Any
amendments to the Public Health Service Act governs the terms of any loans disbursed on or after the effective
date of such amendment, and such amended terms are hereby incorporated into this Note.
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NOTICE: The Institution must require security or endorsement if the Borrower is a minor and if, under the applicable
State law, the Note signed by him or her would not create a binding obligation. The Institution may not require
security or endorsement in any other circumstances. The Institution shall supply a copy of this Note to the Borrower.
I agree to the terms and conditions of this Promissory Note
I accept use of this form as my Master Promissory Note for all loans received under the Nursing Student Loan Program
Date
Borrower Name
Address1
Address2
City State Zip
Date of Birth
School Exit Date
Borrower Signature
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8. NSL Single-Year
GUIDANCE
NURSING STUDENT LOAN PROGRAM
MASTER PROMISSORY NOTE SINGLE
YEAR
NOVEMBER 13, 1998
I, <<First name>><<M.I.) (Last name) , hereinafter called the Borrower, promise to pay to Institution
Name), hereinafter called the Institution located at (City) (State) , the sum of such amounts as may from
time to time be advanced to me and endorsed in the Schedule of Advances below with interest at the rate
of Five (5) percent per annum together with all attorney's fees, collection agent costs, and other related
costs and charges for the collection of any amount not paid when in default according to the terms of this
Promissory Note.
NUMBER
AMOUNT ADVANCED
TOTAL
TO DATE
the Borrower under the Nursing Student Loan program, the sum of the amounts advanced to the Borrower shall be
consolidated for purposes of repayment. Each payment made by the Borrower to the Institution shall be applied first to
interest which has accrued on the unpaid principal balance and then to the principal sum of the total loan.
a. Repayment shall be made in equal or graduated periodic installments within a ten-year repayment period, except
that the Institution may require repayment to be made in an amount equal to not less than $40 per month. The ten year
repayment period begins nine months after the Borrower ceases to be a full-time or half-time student (as defined by
the institution) at a school eligible to participate in the Nursing Student Loan program. Periods of authorized
deferment are not included as part of the ten year repayment period.
b. The terms and conditions of repayment shall be set forth in a separate repayment period schedule which is approved
by the Institution and agreed to by the Borrower. Payments under the repayment schedule shall be made to the
Institution or its representative no less often than quarterly, except that if the Borrower is more than 60 days past due
on a payment, the remaining balance of the loan shall be repaid on a monthly basis.
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3. Interest (Section 836 Public Health Service Act, 42 CFR 57.310): Interest shall accrue from the beginning of the
repayment period.
interest need not be paid, and interest shall not accrue, while the Borrower: (a) serves on active duty as a member of a
up to three years; and (c) pursues, for up to ten years, a fulltime or half-time course of study at a collegiate school of
nursing leading to a baccalaureate degree in nursing or equivalent degree, or a graduate degree in nursing, or
otherwise pursues advanced professional training in nursing or training to be a nurse anesthetist. Advanced
professional training shall include full-time or half-time training, beyond the first diploma or degree in nursing
received by the particular borrower, of at least 1 academic year which will advance the borrower's knowledge of and
strengthen his or her skills in the provision of nursing services.
5. Prepayment (42 CFR 57.310): The Borrower may, at his or her option and without penalty, prepay all or any part
of the principal and accrued interest at any time.
terminating full or half-time student status at the Institution.
7. Default (Section 835 Public Health Service Act, 42 CFR 57.302): If the Borrower fails to make an installment payment when
due or fails to comply with any other term of this Promissory Note, the loan will be considered in default.
entitlement to deferment, if so entitled, at a rate, not to exceed an amount equal to 6 percent, as determined by the
Institution, of the amount of such installment, on loans more than 60 days past due.
other terms of this Promissory Note, the entire unpaid balance of the loan, including interest due and accrued and any
information, to credit bureaus. If the Borrower is more than 120 days past due in making a scheduled repayme nt, the
Institution will disclose the Borrower's delinquent status and any other relevant information to credit bureaus.
11. Collection Agents, Litigation, and Withholding of Services (42 CFR 57.310): If the Borrower fails to make a
scheduled repayment, or fails to comply with any other term of this Promissory Note, the Institution may: (a) refer the
Borrower's loan to a collection agent for further collection efforts; (b) initiate legal proceedings against the Borrower;
(c) withhold Institutional services, such as transcripts and letters of recommendation, from the Borrower; (d) refer the
Borrower's loan to the Secretary of the U.S. Department of Health and Human Services (DHHS) for collection
assistance, including offset of Federal salaries; and (e) obtain the Borrower's address from the Internal Revenue
Service, through the Secretary of DHHS, if the Institution has no current address for the Borrower.
12. Death or Disability (Section 836 Public Health Service Act, 42 CFR 57.311): In the event of the Borrower's
total and permanent disability or death, the unpaid indebtedness remaining on the Promissory Note shall be canceled.
ceases to be a full-time student or half-time student at the Institution. The terms of this Promissory Note shall be
construed according to the Federal statute and regulations governing the administration of the Nursing Student Loan
program, copies of which shall be kept by the Institution.
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Notice about Subsequent Loans Made under This Master Promissory Note
Borrower's request and upon the Institution's determination of the Borrower's loan eligibility.
Subsequent loans may be made under the Note for the same or subsequent periods of enrollment at this
Institution. The Institution however, may at its discretion, close this Note at any time and require the Borrower
to sign a new Note for additional disbursements. If the Institution chooses to make subsequent loans under this
Note, no such loans will be made after the earliest of the following dates: (i) the date this Institution receives the
Borrower's written notice that no further loans may be made disbursed under this note; (ii) the date of withdrawal
from the Institution by the Borrower.
Any amendments to the Public Health Service Act governs the terms of any loans disbursed on or after the
effective date of such amendment, and such amended terms are hereby incorporated into this Note.
State law, the Note signed by him or her would not create a binding obligation. The Institution may not require
security or endorsement in any other circumstances. The Institution shall supply a copy of this Note to the Borrower.
I agree to the terms and conditions of this Promissory Note
I accept use of this form as my Master Promissory Note for all loans received under the Nursing Student
Date
Borrower Name
Address1
Address2
City State Zip
Date of Birth
School Exit Date
Borrower Signature
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9. PCL Multi-Year
GUIDANCE
PRIMARY CARE LOAN PROGRAM MASTER PROMISSORY NOTE
MULTI -YEAR
NOVEMBER 13, 1998
I, <<first name >> <<Last name>> hereinafter called the Borrower, promise to pay to <<Institution Name>>,
hereinafter called the Institution located at <<City>><<State>>, the sum of such amounts as may from time to time be
advanced to me with interest at the rate of Five (5) percent per annum except as specified in #3, together with all
attorney's fees, collection agent costs, and other related costs and charges for the collection of any amount not paid
when in default according to the terms of this Promissory Note.
1. Agreement to enter and practice primary health care (Section 723 Public Health Service Act:
a. enter and complete a residency training program in primary health care not later than 4 years after the date on which
the Borrower graduates from the Institution; b. practice in primary health care in a State (as defined in 42
USC 295) through the date on which the loan is repaid in full, and certify to the Institution on an annual basis until the
loan is repaid in full that he/she is practicing in primary health care; c. not enter any subspecialty training (i.e. nonprimary care residency, fellowships, etc. that could lead to board certification in a subspecialty) from the time
of graduation until the loan is repaid in full.
2. Definitions (Section 723 Public Health Service Act):
a. Primary Health Care is defined as family medicine, general internal medicine, general pediatrics, preventive
medicine or osteopathic general practice. b. Residency Training Program in Primary Health Care is defined as a 3 year residency program in allopathic or osteopathic family medicine, internal medicine, pediatrics, combined
medicine/pediatrics, or preventive medicine, approved by the Accreditation Council on Graduate Medical Education
(ACGME) or the American Osteopathic Association (AOA) or a general practice residency program approved by
the AOA. This may include participation in a rotating or primary health care internship approved by the AOA.
3. Non-Compliance By Borrower (Section 723 Public Health Service Act):
a. This loan will accrue interest continuously at a rate of eighteen (18) percent per annum beginning on the date of
noncompliance, and ending when the loan is paid in full. b. The Borrower is not eligible for the deferment provisions
outlined in #7 of this Promissory Note.
4. Prohibition Against Consolidation: This Loan may not be consolidated as part of a Federal Consolidation Loan
under the Higher Education Act of 1965.
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period begins one year after the Borrower ceases to be a full-time student at a school eligible to participate in the
Primary Care Loan program. The repayment period shall not be less than ten years, nor more than 25 years, at the
b. The terms and conditions of repayment shall be set forth in a separate repayment schedule which is approved by the
Institution and agreed to by the Borrower. Payments under the repayment schedule shall be made to the Institution or
its representative no less often than quarterly, except that if the Borrower is more than 60 days past due on a payment,
the remaining balance of the loan shall be repaid on a monthly basis.
6. Interest (Section 722 Public Health Service Act, 42 CFR 57.208: Interest shall accrue from the beginning of the
repayment period, except as specified in #3.
7. Deferment (Section 722, 42 CFR 57.210): In accordance with #1. above, periodic installments of principal and
interest need not be paid, and interest shall not accrue while the Borrower: (a) serves on active duty as a member of a
up to three years; (c) pursues advanced professional training in primary care, including internships and residencies; (d)
pursues a full-time course of study at a health professions school eligible for participation in the Primary Care Student
Loan program; (e) leaves the Institution, with the intent to return to the Institution as a fulltime student, to engage in a
full-time educational activity which is directly related to the health profession for which the Borrower is preparing, as
determined by the Secretary of Health and Human Services (the Secretary), for up to two years; and (f) participates in
a fellowship training program or a full-time educational activity which is directly related to the health profession for
which the Borrower prepared at the Institution, and is engaged in by the Borrower within 12 months after the
completion of the Borrower's participation in advanced professional training (described in #7(c) above) or prior to the
completion of the Borrower's participation in such training, for up to two years.
10. Default (Section 721, 42 CFR 57.208): If the Borrower fails to make an installment payment when due or fails to
comply with any other term of this Promissory Note, except for #1 above, the loan will be considered in default.
entitlement to deferment, if so entitled, at a rate, not to exceed an amount equal to 6 percent as determined by the
Institution of the amount of such installment, on loans more than 60 days past due.
other term of this Promissory Note, except as specified in #3 above, the entire unpaid balance of the loan, including
interest due and accrued and any applicable penalty charges, will, at the option of the Institution, become immediately
due and payable.
CFR 57.210): If the Borrower fails to make a scheduled repayment, or fails to comply with any other term of this
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Promissory Note, except for #1 above, the Institution may: (a) refer the Borrower's loan to a collection agent for
further collection efforts; (b) initiate legal proceedings against the Borrower; (c) withhold Institutional services, such
as transcripts and letters of recommendation, from the Borrower; (d) refer the Borrower's loan to the Secretary for
collection assistance, including offset of Federal salaries; and (e) obtain the Borrower's address from the Internal
Revenue Service through the Secretary, if the Institution has no current address for the Borrower.
cancellations.
16. Waiver or Suspension of Service Obligation (Section 723):
a. If the Borrower does not graduate from a school of medicine or osteopathic medicine, the agreement set forth in
#1 above and the noncompliance provisions set forth in #3 above shall be waived upon approval by the Secretary.
b. If the Borrower terminates his or her studies before graduating from a school of medicine or osteopathic
medicine, but later resumes studies and graduates from a school of medicine or osteopathic medicine, the
agreement set forth in #1above and the noncompliance provisions set forth in #3 above shall be considered to have
been suspended for the period during which the Borrower was not in attendance at a school of medicine or
osteopathic medicine and the original loan terms reinstated. c. This section may not be construed as authorizing the
waiver or suspension of the obligation of the Borrower to repay this loan in accordance with the terms of this
Promissory
Note.
the Federal statute and regulations governing the administration of the Health Professions Student Loan and Primary
Care Loan programs, copies of which shall be kept by the Institution.
Borrower's written notice that no further loans may be made disbursed under this note; (ii) the date of
withdrawal from the Institution by the Borrower.
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Borrower.
I accept use of this form as my Master Promissory Note for all loans received under the Primary Care Loan (PCL) program.
Date
Borrower Name
Address1
Address2
City State Zip
Date of Birth
School Exit Date
Borrower Signature
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10. PCL Single-Year
GUIDANCE
PRIMARY CARE LOAN PROGRAM MASTER PROMISSORY NOTE
SINGLE YEAR
NOVEMBER 13, 1998
I, <<first name >> <<Last name>> hereinafter called the Borrower, promise to pay to <<Institution Name>>,
hereinafter called the Institution located at <<City>><<State>>, the sum of such amounts as may from time to time
be advanced to me and endorsed in the Schedule of Advances below with interest at the rate of Five (5) percent per
annum except as specified in #3, together with all attorney's fees, collection agent costs, and other related costs and
charges for the collection of any amount not paid when in default according to the terms of this Promissory Note.
NUMBER
AMOUNT ADVANCED
TOTAL
TO DATE
1. Agreement to enter and practice primary health care (Section 723 Public Health Service Act:
a. enter and complete a residency training program in primary health care not later than 4 years after the date on
which the Borrower graduates from the Institution; b. practice in primary health care in a State (as defined in 42
USC 295) through the date on which the loan is repaid in full, and certify to the Institution on an annual basis until
the loan is repaid in full that he/she is practicing in primary health care; c. not enter any subspecialty training (i.e.
non-primary care residency, fellowships, etc. that could lead to board certification in a subspecialty) from the time of
graduation until the loan is repaid in full.
2. Definitions (Section 723 Public Health Service Act):
a. Primary Health Care is defined as family medicine, general internal medicine, general pediatrics, preventive
medicine or osteopathic general practice. b. Residency Training Program in Primary Health Care is defined as a 3 year residency program in allopathic or osteopathic family medicine, internal medicine, pediatrics, combined
medicine/pediatrics, or preventive medicine, approved by the Accreditation Council on Graduate Medical Education
(ACGME) or the American Osteopathic Association (AOA) or a general practice residency program approved by
the AOA. This may include participation in a rotating or primary health care internship approved by the AOA.
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3. Non-Compliance By Borrower (Section 723 Public Health Service Act):
a. This loan will accrue interest continuously at a rate of eighteen (18) percent per annum beginning on the date of
non-compliance, and ending when the loan is paid in full. b. The Borrower is not eligible for the deferment
provisions outlined in #7 of this Promissory Note.
4. Prohibition Against Consolidation: This Loan may not be consolidated as part of a Federal Consolidation Loan
under the Higher Education Act of 1965.
period begins one year after the Borrower ceases to be a full-time student at a school eligible to participate in the
Primary Care Loan program. The repayment period shall not be less than ten years, nor more than 25 years, at the
b. The terms and conditions of repayment shall be set forth in a separate repayment schedule which is approved by
the Institution and agreed to by the Borrower. Payments under the repayment schedule shall be made to the Institution
or its representative no less often than quarterly, except that if the Borrower is more than 60 days past due on a
payment, the remaining balance of the loan shall be repaid on a monthly basis.
6. Interest (Section 722 Public Health Service Act, 42 CFR 57.208: Interest shall accrue from the beginning of the
repayment period, except as specified in #3.
7. Deferment (Section 722, 42 CFR 57.210): In accordance with #1. above, periodic installments of principal and
interest need not be paid, and interest shall not accrue while the Borrower: (a) serves on active duty as a member of a
up to three years; (c) pursues advanced professional training in primary care, including internships and residencies;
(d) pursues a full-time course of study at a health professions school eligible for participation in the Primary Care
Student Loan program; (e) leaves the Institution, with the intent to return to the Institution as a fulltime student, to
engage in a full-time educational activity which is directly related to the health profession for which the Borrower is
preparing, as determined by the Secretary of Health and Human Services (the Secretary), for up to two years; and (f)
participates in a fellowship training program or a full-time educational activity which is directly related to the health
profession for which the Borrower prepared at the Institution, and is engaged in by the Borrower within 12 months
after the completion of the Borrower's participation in advanced professional training (described in #7(c) above) or
prior to the completion of the Borrower's participation in such training, for up to two years.
10. Default (Section 721, 42 CFR 57.208): If the Borrower fails to make an installment payment when due or fails to
comply with any other term of this Promissory Note, except for #1 above, the loan will be considered in default.
11. Late Charge (Section 721 Public Health Service Act, 42 CFR 57.210): The Institution shall assess a late
penalty charge for failure of the Borrower to pay all or any part of an installment, or for failure to file satisfactory
evidence of entitlement to deferment, if so entitled, at a rate, not to exceed an amount equal to 6 percent as
determined by the Institution of the amount of such installment, on loans more than 60 days past due.
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other term of this Promissory Note, except as specified in #3 above, the entire unpaid balance of the loan, including
interest due and accrued and any applicable penalty charges, will, at the option of the Institution, become immediately
due and payable.
CFR 57.210): If the Borrower fails to make a scheduled repayment, or fails to comply with any other term of this
Promissory Note, except for #1 above, the Institution may: (a) refer the Borrower's loan to a collection agent for
further collection efforts; (b) initiate legal proceedings against the Borrower; (c) withhold Institutional services, such
as transcripts and letters of recommendation, from the Borrower; (d) refer the Borrower's loan to the Secretary for
collection assistance, including offset of Federal salaries; and (e) obtain the Borrower's address from the Internal
Revenue Service through the Secretary, if the Institution has no current address for the Borrower.
cancellations.
16. Waiver or Suspension of Service Obligation (Section 723):
a. If the Borrower does not graduate from a school of medicine or osteopathic medicine, the agreement set forth in
#1 above and the noncompliance provisions set forth in #3 above shall be waived upon approval by the Secretary.
b. If the Borrower terminates his or her studies before graduating from a school of medicine or osteopathic medicine,
but later resumes studies and graduates from a school of medicine or osteopathic medicine, the agreement set forth in
#1above and the noncompliance provisions set forth in #3 above shall be considered to have been suspended for the
period during which the Borrower was not in attendance at a school of medicine or osteopathic medicine and the
original loan terms reinstated.
c. This section may not be construed as authorizing the waiver or suspension of the obligation of the Borrower to
repay this loan in accordance with the terms of this Prom Note.
the Federal statute and regulations governing the administration of the Health Professions Student Loan and Primary
Care Loan programs, copies of which shall be kept by the Institution.
Borrower's written notice that no further loans may be made disbursed under this note; (ii) the date of withdrawal
from the Institution by the Borrower.
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State law, the Note signed by him or her would not create a binding obligation. The Institution may not require security
or endorsement in any other circumstances. The Institution shall supply a copy of this Note to the Borrower.
I accept use of this form as my Master Promissory Note for all loans received under the Primary Care Loan (PCL) program.
Date
Borrower Name
Address1
Address2
City State Zip
Date of Birth
School Exit Date
Borrower Signature
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11. Federal Perkins Loan Master Promissory Note
1. Name (last, first, middle initial) and
Permanent Address (street, city, state, zip code)
2. Social Security Number
3. Date of Birth (mm/dd/yyyy)
4. Home Area Code/Telephone Number
5. Driver's License Number (List state abbreviation first)
6. School Name & Address (street, city, state, zip code)
7. Annual Interest Rate
5%
Terms and Conditions: (Note: Additional Terms and Conditions follow on subsequent pages)
APPLICABLE LAW - The terms of this Federal Perkins Loan Master Promissory Note (hereinafter called the Note) and any disbursements made under this Note shall be interpreted in accordance
with Part E of Title IV of the Higher Education Act of 1965, as amended (hereinafter called the Act), as well as Federal regulations issued under the Act. All sums advanced under this Note are
subject to the Act and Federal regulations issued under the Act.
REPAYMENT - I am obligated to repay the principal and the interest that accrues on my loan(s) to the above-named institution (hereinafter called the School) over a period beginning 9 months (or
sooner if I am a Less-Than-Half-Time Borrower) after the date I cease to be at least a half-time student at an institution of higher education or a comparable School outside the United States
approved by the United States Department of Education (hereinafter called the Department) and ending 10 years later, unless I request in writing that my repayment period begin sooner. I
understand that the School will report the amount of my installment payments, along with the amount of this loan to at least one national credit bureau. Interest on this loan shall accrue from the
beginning of the repayment period. My repayment period may be shorter than 10 years if I am required by my School to make minimum monthly payments. My repayment period may be
extended during periods of deferment, hardship, or forbearance and I may make graduated installments in accordance with a schedule approved by the Department. I will make my installment
payments in equal monthly, bimonthly, or quarterly installments as determined by the School. The School may round my installment payment to the next highest multiple of $5. [I will make a
minimum monthly repayment of $40 (or $30 if I have outstanding Federal Perkins Loans made before October 1, 1992 that included the $30 minimum payment option or outstanding National
Direct Student Loans) in accordance with the Minimum Monthly Payment Section of the Terms and Conditions contained on the reverse side of this document.]
LATE CHARGES - The School may impose late charges if I do not make a scheduled payment when due or if I fail to submit to the School on or before the due date of the payment, a properly
documented request for any of the forbearance, deferment, or cancellation benefits as described below. No late charges may exceed 20 percent of my monthly, bimonthly, or quarterly payment.
The School may add the late charges to principal the day after the scheduled payment was due or include it with the next scheduled payment after I have received notice of the charge, and such
notice is sent before the next installment is due.
FORBEARANCE, DEFERMENT, OR CANCELLATION - I may apply for a forbearance, deferment, or cancellation on my loan. During an approved forbearance period, payments of principal and
interest, or principal only, may be postponed or reduced. Interest continues to accrue while my loan is in forbearance. During an approved deferment period, I am not required to make scheduled
installment payments on my loan. I am not liable for any interest that might otherwise accrue while my loan is in deferment. If I meet the eligibility requirements for a cancellation of my loan, the
institution may cancel up to 100 percent of the outstanding principal loan amount. Information on eligibility and application requirements for forbearances, deferments, and cancellations is
provided on pages 2 through 4 of this Note. I am responsible for submitting the appropriate requests on time, and I may lose my benefits if I fail to file my request on time.
DEFAULT - The School may, at its option, declare my loan to be in default if (1) I fail to make a scheduled payment when due; (2) I fail to submit to the School, on or before the due date of a
scheduled payment, documentation that I qualify for a forbearance, deferment, or cancellation; or (3) I fail to comply with the terms and conditions of this Note or written repayment agreement.
The School may assign a defaulted loan to the Department for collection. I will be ineligible for any further federal student financial assistance authorized under the Act until I make arrangements
that are satisfactory to the School or the Department to repay my loan. The School or the Department shall disclose to credit bureau organizations that I have defaulted and all other relevant loan
information. I will lose my right to defer payments and my right to forbearance if I default on my loan. The School or the Department may accelerate my defaulted loan. Acceleration means that
the School or the Department demands immediate payment of the entire unpaid balance of the loan, including principal, interest, late charges, and collection costs. I will lose my right to receive
cancellation benefits for service that is performed after the date the School or the Department accelerated the loan.
CHANGE OF STATUS - I will inform the School of any change in my name, address, telephone number, Social Security Number, or driver's license number.
AUTHORIZATION: - I authorize the School, the Department, and their respective agents and contractors to contact me regarding my loan request or my loan(s), including repayment of my loan(s),
at the current or any future number that I provide for my cellular phone or other wireless device using automated telephone dialing equipment or artificial or pre-recorded voice or text messages.
PROMISE TO PAY: I promise to pay the School, or a subsequent holder of the Note, all sums disbursed under the terms of this Note, plus interest and other fees which may become due as provided
in this Note. I understand that multiple loans may be made to me under this Note. I understand that by accepting any disbursements issued at any time under this Note, I agree to repay the
loans. I understand that each loan is separately enforceable based on a true and exact copy of this Note. I understand that I may cancel or reduce the amount of any loan by not accepting or by
returning all or a portion of any disbursement that is issued. If I do not make any payment on any loan under this Note when it is due, I promise to pay all reasonable collection costs, including
attorney fees, court costs, and other fees. I will not sign this Note before reading the entire Note, even if I am told that I am not required to read it. I am entitled to an exact copy of this Note. This
loan has been made to me without security or endorsement. My signature certifies I have read, understand, and agree to the terms and conditions of this Note.
I UNDERSTAND THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS MASTER PROMISSORY NOTE AND THAT I MUST REPAY SUCH LOANS.
Borrower’s Signature
Date
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Terms and Conditions (cont.)
DISCLOSURE OF LOAN TERMS - I understand that under this Note, the principal
amount that I owe, and am required to repay, will be the sum of all disbursements
issued unless I reduce or cancel any disbursements. The School will determine
whether to make any loan under this Note after my loan eligibility is determined. At
or before the time of first disbursement for each loan, a disclosure statement will be
provided to me identifying the amount of the loan and any additional terms of the
loan. I may decline a loan or request a lower amount by contacting the School. Any
disclosure statement I receive in connection with any loan under this Note is hereby
incorporated into this Note.
LOAN REHABILITATION - If I default on my Federal Perkins Loan, and that loan has
not been reduced to a judgment as a result of litigation against me, I may
rehabilitate my defaulted loan by requesting the rehabilitation and by making a
voluntary, on-time, monthly payment, as determined by the School, each month for
nine consecutive months. If I successfully rehabilitate my defaulted Federal Perkins
Loan, I will again be subject to the terms and conditions and qualify for any
remaining benefits and privileges of this Note and the default will be removed from
my credit history. I understand that I may rehabilitate a defaulted Federal Perkins
Loan only once. After my loan is rehabilitated, collection costs on the loan may not
exceed 24 percent of the unpaid principal and accrued interest as of the date
following the application of the ninth consecutive payment. If I default on my
rehabilitated loan, the cap on collection costs is removed.
ASSIGNMENT - A loan made under this Note may be assigned by the School only to
the United States, as represented by the United States Department of Education.
Upon assignment, the provisions of this Note that relate to the School will, where
appropriate, relate to the Department.
HARDSHIP REPAYMENT OPTIONS - Upon my written request, the School may
extend my repayment period (1) for up to an additional 10 years if I qualify as a lowincome individual during the repayment period; or (2) for the period necessary
beyond my 10 year repayment period if, in the School’s opinion, prolonged illness
or unemployment prevent me from making the scheduled repayments. Interest
will continue to accrue during any extension of a repayment period.
If I am required by the School to make a minimum monthly payment on my loan,
the School may also permit me to pay less than the minimum monthly payment
amount for a period of not more than one year at a time if I experience a period of
prolonged illness or unemployment. However, such action may not extend the
repayment period beyond 10 years.
GRACE PERIODS - Unless I am a Less-Than-Half-Time Borrower, I will receive an
initial nine-month grace period before the first payment of my Federal Perkins Loan
must be made. After the close of an authorized deferment period, I will receive a
post-deferment grace period of 6 months before my payments resume. Interest
does not accrue during the initial grace period or during the post-deferment grace
period. The nine-month initial grace period for Federal Perkins Loans does not
include any period up to three years during which I am called or ordered to active
duty for more than 30 days from a reserve component of the Armed Forces of the
United States, including the period necessary for me to resume enrollment at the
next available enrollment period. I must notify the school that made my loan of the
beginning and ending dates of my service, and the date I resume enrollment. If I am
in my initial grace period when called or ordered to active duty, I am entitled to a
new nine-month initial grace period upon completion of the excluded period.
If I am a Less-Than-Half-Time Borrower with outstanding Federal Perkins Loans, my
repayment period begins when the next scheduled installment of my outstanding
loan is due. If I am a Less-Than-Half-Time Borrower with no other outstanding
Federal Perkins Loans, my repayment begins the earlier of: 9 months from the date
my loan was made, or 9 months from the date I became a less-than-half-time
student, even if I received the loan after I became a less-than-half-time student.
PREPAYMENT - I may prepay all or any part of my unpaid loan balance, plus any
accrued interest, at any time without penalty. Amounts I repay in the academic
year in which the loan was made and before the initial grace period has ended will
used to reduce the amount of the loan and will not be considered a prepayment. If
I repay amounts during the academic year in which the loan was made and the
initial grace period has ended, only those amounts in excess of the amount due for
any repayment period shall be considered a prepayment. If, in an academic year
other than the academic year in which the loan was made, I repay more than the
amount due for an installment, the excess funds will be used to repay principal
unless I designate it as an advance payment of the next regular installment.
MINIMUM MONTHLY PAYMENT - If required by the School, I will make a minimum
monthly payment in the amount of $40 (or $30 if I have outstanding Federal
Perkins Loans made before October 1, 1992 that included the $30 minimum
payment option or outstanding National Direct Student Loans) or its bimonthly or
quarterly equivalent. If the total monthly payment amount on this loan and any
outstanding Federal Perkins Loans I may have is less than the minimum monthly
payment amount established by the School, the School may still require a minimum
monthly payment amount. A minimum monthly payment amount will combine my
obligation on this and all my outstanding Federal Perkins Loans, unless I have
received loans with different grace periods and deferments. At my request and if I
am eligible, the school may combine this minimum monthly payment amount with
all my outstanding Federal Perkins Loans including those made at other schools.
Under these circumstances the portions of the minimum monthly payment that will
be applied to this loan will be the difference between the minimum monthly
payment amount and the total amounts owed on a monthly basis on my other
Federal Perkins Loans. If each school holding my outstanding Federal Perkins Loans
exercises the minimum monthly payment amount option, the minimum monthly
payment amount will be divided among the Schools in proportion to the loan
amount advanced by each school if I request this treatment from each School.
FORBEARANCE - Upon making a properly documented written or oral request to
the School, I am entitled to forbearance of principal and interest or principal only,
renewable at intervals of up to 12 months for periods that collectively do not
exceed three years, under the following conditions: If my monthly Title IV loan debt
burden equals or exceeds 20 percent of my total monthly gross income; if the
Department authorizes a period of forbearance due to a national military
mobilization or other national emergency; or if the School determines that I qualify
due to poor health or for other reasons, including service in AmeriCorps. Interest
accrues during any period of forbearance.
DEFERMENTS - To apply for a deferment, I must request the deferment from the
school. My request does not have to be in writing, but the School may require that I
submit supporting documentation to prove my eligibility for a deferment. I may
defer making scheduled installment payments and will not be liable for any interest
that might otherwise accrue (1) during any period that I am enrolled and attending
as a regular student in at least a half-time course of study at an eligible School (if the
School obtains student enrollment information showing that I qualify for this
deferment, the School may grant the deferment without my request providing the
School notifies me and gives me the option to cancel the deferment); (2) during any
period that I am enrolled and attending as a regular student in a graduate
fellowship program approved by the Department; engaged in graduate or postgraduate fellowship-supported study outside the US; enrolled and attending a
rehabilitation training program for disabled individuals approved by the
Department; or engaged in public service that qualifies me to have part or all of my
loan canceled; (3) for a period not to exceed three years during which I am seeking
but unable to find full-time employment; (4) for a period not to exceed three years,
for up to one year at a time, during which I am experiencing an economic hardship
as determined by the School. I may qualify for an economic hardship deferment for
my Federal Perkins Loan if I provide my school with documentation showing that I
have been granted such a deferment under the William D. Ford Federal Direct Loan
or Federal Family Education Loan program for the period of time for which I am
requesting an economic hardship deferment for my Federal Perkins Loan. If I am
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serving as a volunteer in the Peace Corps, I am eligible for an economic hardship
deferment for my full term of service. An economic hardship deferment based on
service as a Peace Corps volunteer may not exceed the lesser of three years or my
remaining period of economic hardship eligibility; (5) , during any period when I am
serving on active duty during a war or other military operation or national
emergency, or performing qualifying National Guard duty during a war or other
military operation or national emergency (as these terms are defined in 34 CFR
674.34(h) of the Perkins Loan Program regulations) and, if my active duty service
includes October 1, 2007 or begins on or after that date, for an additional 180day period following the demobilization date for my service; and (6) if I am
serving on active duty military service on October 1, 2007, or begin serving on or
after that date, for at least a 30-day period, for up to 13 months following the
conclusion of my active duty military service and initial grace period or until I
return to enrolled student status, whichever is earlier, if I am a member of the
National Guard or other reserve component of the Armed Forces of the United
States or a member of such forces in retired status (as these terms are defined in
34 CFR 674.34(i)(2)) and I was enrolled in a program of instruction at the time I
was called to active duty, or within six months prior to the time I was called to
active duty. Active duty does not include active duty for training or attendance
at a service school or employment in a full-time, permanent position in the
National Guard unless I am reassigned from that position to another form of
active duty service.
I may continue to defer making scheduled installment payments and will not be
liable for any interest that might otherwise accrue for a six-month period
immediately following the expiration of any deferment period described in this
section.
I am not eligible for a deferment while serving in a medical internship or residency
program.
CANCELLATIONS - Upon making a properly documented written request to the
School, I am entitled to have up to 100 percent of the original principal loan amount
of this loan canceled if I perform qualifying service in the areas listed in paragraphs
A through K below. Other cancellation percentages apply if I perform qualifying
service in the areas listed in paragraphs L and M, as explained in those paragraphs.
Qualifying service must be performed after the enrollment period covered by the
loan.
A. Teaching  a full-time teacher in a public or other nonprofit elementary or
secondary school or in a school or location operated by an educational service
agency that has been designated by the Department in accordance with the
provisions of section 465(a)(2) of the Act as a school with a high concentration of
students from low-income families. An official Directory of designated low-income
schools and locations operated by educational service agencies is published
annually by the Department.  a full-time special education teacher in a public or
nonprofit elementary or secondary school system, including a system administered
by an educational service agency; or  a full-time teacher, in a public or other
nonprofit elementary or secondary school system who teaches mathematics,
science, foreign languages, bilingual education, or any other field of expertise that is
determined by the State Department of Education to have a shortage of qualified
teachers in that State.
B. Early Intervention Services  a full-time qualified professional provider of early
intervention services in a public or other nonprofit program under public
supervision by a lead agency as authorized by section 632(5) of the Individuals with
Disabilities Education Act. Early intervention services are provided to infants and
toddlers with disabilities.
C. Law Enforcement or Corrections Officer  a full-time law enforcement officer for
an eligible local, State, or Federal law enforcement agency; or  a full-time
corrections officer for an eligible local, State, or Federal corrections agency.
D. Nurse or Medical Technician  a full-time nurse providing health care services; or
 a full-time medical technician providing health care services.
E. Child or Family Service Agency  a full-time employee of an eligible public or
private non-profit child or family service agency who is directly providing or
supervising the provision of services to high-risk children who are from low-income
communities and the families of such children.
F. Attorneys Employed in a Defender Organization  a full-time attorney
employed in a defender organization established in accordance with section
3006(g)(2) of title 18, U.S.C.
G. Firefighters  a full-time firefighter for a local, State or Federal fire department or
fire district.
H. Tribal College or University Faculty  a full-time faculty member at a Tribal
College or University, as that term is defined in section 316 of title 20, U.S.C.
I. Librarian  a full-time librarian who has a master’s degree in library science and is
employed in an elementary or secondary school that is eligible for assistance under
part A of title I of the Elementary and Secondary Education Act of 1965, or who is
employed in a public library that serves a geographic area that contains one or
more such schools.
J. Speech-Language Pathologist  a full-time speech-language pathologist who has
a master’s degree and who is working exclusively with schools that are eligible for
assistance under title I of the Elementary and Secondary Education Act of 1965.
K. Service in an Early Childhood Education Program  a full-time staff member in
the educational component of a Head Start program, or a full-time staff member in
a pre-kindergarten or child care program that is licensed or regulated by the State.
The program must be operated for a period comparable to a full School year and
must pay a salary comparable to an employee of a local educational agency.
Cancellation Rates - For each completed year of service under paragraphs A, B, C,
D, E, F, G, H, I, and J a portion of this loan will be canceled at the following rates:
 15 percent of the original principal loan amount for each of the first and second
years;  20 percent of the original principal loan amount for each of the third and
fourth years; and  30 percent of the original principal loan amount for the fifth
year.
For each completed year of service under paragraph K (Service in an Early
Childhood Education Program), a portion of this loan will be canceled at the rate of
15 percent of the original principal loan amount.
L. Military Cancellation - Upon making a properly documented written request to
the School, I am entitled to have up to 50 percent of the principal amount of this
loan canceled for qualifying service that ended before August 14, 2008, and up to
100 percent cancelled for qualifying service that began on or after August 14,
2008, as:  a member of the Armed Forces of the United States in an area of
hostilities that qualifies for special pay under section 310 of Title 37 of the United
States Code.
Cancellation Rate - For each completed year of service under the Military
Cancellation provision that ended before August 14, 2008, this loan will be canceled
at the rate of 12½ percent of the original principal loan amount.
For qualifying service that began on or after August 14, 2008, this loan will be
canceled at the following rates:  15 percent of the original principal loan amount
for each of the first and second years;  20 percent of the original principal loan
amount for each of the third and fourth years; and  30 percent of the original
principal loan amount for the fifth year.
M. Volunteer Service Cancellation - Upon making a properly documented written
request to the School, I am entitled to have up to 70 percent of the original principal
loan amount of this loan canceled for qualifying service performed after the
enrollment period covered by the loan as:  a volunteer under the Peace Corps Act;
 a volunteer under the Domestic Volunteer Service Act of 1973 (ACTION
programs).
Cancellation Rate - For each completed year of service under the Volunteer Service
Cancellation provision, a portion of this loan will be canceled at the following rates:
 15 percent of the original principal loan amount for each of the first and second
12-month periods of service; and  20 percent of the original principal loan amount
for each of the third and fourth 12-month periods of service.
DISCHARGES - My obligation to repay this loan may be partially or totally
discharged for the reasons specified in paragraphs A, B, C, and D below.
A. Death - In the event of my death, the School will discharge the total amount
owed on this loan.
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B. Total and Permanent Disability - Upon making a properly documented written
request to the School, the total amount owed on this loan may be discharged if the
U.S. Department of Education determines that I am totally and permanently
disabled as defined in the Act and I meet certain other requirements.
C. School Closure - Under certain conditions, my total liability will be discharged,
including refunding any amounts I have already paid on the loan, if I was unable to
complete the program in which I was enrolled because my School closed.
D. Bankruptcy - Under certain conditions, my loan may be discharged in
bankruptcy. In order to discharge a loan in bankruptcy, I must prove undue
hardship in an adversary proceeding before the bankruptcy court.
Disclosure of Information
STUDENT LOAN OMBUDSMAN - If I dispute the terms of my Federal Perkins
Loan in writing to my School, and my School and I are unable to resolve the
dispute, I may seek the assistance of the Department of Education’s Student
Loan Ombudsman. The Student Loan Ombudsman will review and attempt
to informally resolve the dispute.
Notice About Subsequent Loans Made Under This Master Promissory Note
This Note authorizes the School to disburse multiple loans during the
multi-year term of this Note upon my request and upon the School's
determination of my loan eligibility.
Subsequent loans may be made under this Note for the same or
subsequent periods of enrollment at this School. The School, however, may,
at its discretion, close this Note at any time and require me to sign a new
Note for additional disbursements. I understand that if my School chooses to
make subsequent loans under this Note, no such loans will be made after the
earliest of the following dates: (i) the date the School receives my written
notice that no further loans may be disbursed under this Note; (ii) twelve
months after the date of my signature on this Note if no disbursement is
made during such twelve-month period; or (iii) ten years after the date of my
signature on this Note, or the date the School receives this Note.
Any amendment to the Act governs the terms of any loans disbursed on or
after the effective date of such amendment, and such amended terms are
hereby incorporated into this Note.
Important Notice
Privacy Act Notice
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §461 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1087aa
et seq.) and the authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b).
Participating in the Federal Perkins Loan (Perkins) Program and giving us your SSN are voluntary, but you must provide the requested information, including your SSN,
to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a
benefit on a loan (such as a deferment, forbearance, discharge, or forgiveness) under the Perkins Program, to permit the servicing of your loan(s), and, if it becomes
necessary, to locate you and to collect and report on your loan(s) if your loan(s) become delinquent or in default. We also use your SSN as an account identifier and
to permit you to access your account information electronically.
The information in your file may be disclosed, on a case by case basis or under a computer matching program, to third parties as authorized under routine uses in the
appropriate systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to
private parties such as relatives, present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational
institutions, and to guaranty agencies in order to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or
collection of your loan(s), to enforce the terms of the loan(s), to investigate possible fraud and to verify compliance with federal student financial aid program
regulations, or to locate you if you become delinquent in your loan payments or if you default. To provide default rate calculations, disclosures may be made to
guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history information, disclosures may be made to educational
institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty agencies, to financial and educational
institutions, or to federal or state agencies. To provide a standardized method for educational institutions efficiently to submit student enrollment status, disclosures
may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty agencies,
to financial and educational institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and
necessary to the litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate
authority for action. We may send information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving
employment complaints, grievances, or disciplinary actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective
bargaining agreement, we may disclose records to a labor organization recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the
purpose of performing any programmatic function that requires disclosure of records. Before making any such disclosure, we will require the contractor to maintain
Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act safeguards.
Financial Privacy Act Notice
Under the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401-3421), the U.S. Department of Education will have access to financial records in your student loan file
maintained by the lender in compliance with the administration of the Federal Perkins Loan Program.
Paperwork Reduction Notice
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control
number. The valid OMB control number for this information collection is 1845-0074. The time required to complete this information is estimated to average 0.5
hours (30 minutes) per response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and
review the information collection. The obligation to respond to this collection is required to obtain or retain benefit, Higher Education Act of 1965, as amended (20
U.S.C. 1087dd). If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to:
U.S. Department of Education
Washington, DC 20202-4537
If you have any comments or concerns regarding the status of your individual submission of this form, write directly to the lender.
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12. HPSL, LDS, PCL, NSL Total Loan Indebtedness Disclosure
Award Year: YYYY
TRUTH-IN-LENDING/TOTAL LOAN
INDEBTED DISCLOSURE
<<PROGRAM DESCRIPTION>>
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<<Program Description>> Statement of Rights and Responsibilities
A <<Program Description>> is a serious legal obligation. Therefore, it is extremely important that you understand
your rights and responsibilities and you agree to honor them.
1. I understand that I must, without exception, report any of the following changes to if:
a. I withdraw from school.
b. My address or my parent’s address changes.
c. I drop below full-time status (half-time for Nursing Loan).
d. My name should change (for example because of marriage).
e. I transfer to another school.
f. I join the military service or Peace Corps.
2. I understand that when I graduate or withdraw from <<school name>>, I must arrange for an exit interview by
calling <<school name>>.
3. I understand that my first payment will be due twelve (12) months (nine months (9) if Nursing Student Loan)
from the time I cease to be a full-time student.
4. I understand that my minimum payment will be at least $40.00. It may be more if the amount borrowed is
sufficient to require larger payments.
5. I understand that the ANNUAL PERCENTAGE RATE shown above will be charged on the unpaid balance and
that it will begin to accrue twelve (12) months (nine (9) months if Nursing Loan), after I cease to be enrolled as a
full-time student (half-time for Nursing Loan).
6. I understand that cancellation may be granted for death or permanent and total disability. I also understand the
school must be informed of such a status.
7. I understand that if I enter the military service or Peace Corps, or pursue advanced professional training, I may
request that the payments on my loan be deferred.
8. I understand that if I fail to repay my loan as agreed, the total loan may become due and payable immediately and
legal action could be taken against me.
9. I understand that I must promptly answer any communication regarding my loan.
10. I understand that if I cannot make a payment on time, I must contact the school.
11. I authorize <<school name >>to contact any school which I may attend to obtain information concerning my
student status, my year of study, my dates of attendance, graduation, or withdrawal, my transfer to another school, or
my current address.
12. I authorize << school name>> to report this loan to credit bureaus.
I understand that the Total Loan Indebtedness Disclosure presented to me will serve as an itemization of the
amount financed to date.
I have received/printed a copy of this statement.
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13. Institutional TLID
Award Year: YYYY
TRUTH-IN-LENDING/TOTAL LOAN
INDEBTED DISCLOSURE
<<PROGRAM DESCRIPTION>>
I understand that:
1. My <<PROGRAM DESCRIPTION>> Loan is a LOAN and must be repaid in full, even if I do not complete my
program of study, am dissatisfied with my education, or am unable to secure employment upon completion of my
program.
2. THE ANNUAL PERCENTAGE INTEREST RATE will be charged on the unpaid principal balance and will begin
to accrue after my initial grace period expires. If I repay more than the amount due for an installment, the excess will
be used to repay principal unless I designate it as an advance payment of the next regular installment or my
Promissory Note states otherwise.
3. If I am unable to pay on time, I must contact and make arrangements with the Business/Loan Office of the campus
from which this loan was received as that campus holds my promissory note.
4. If I fail to a) make scheduled payments when due or comply with the terms and conditions of the Note or written
repayment agreement, <<University Campus Name>> may declare my loan in default and the entire unpaid balance,
including principal, interest, late charges, and collection costs may become immediately due and payable. Failure to
pay my loan may prevent me from registering at <<University Campus Name>> or obtaining official copies of my
student records including grades, transcripts and diplomas or make me ineligible to receive any additional financial
aid funds.
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5. Collection agencies may be used to collect loans, which become past due and will result in my paying additional
collection costs. Attorneys and legal firms may be used to collect loans in default which will result in my paying
reasonable attorney’s fees plus other costs of collection. I authorize <<University Campus Name>> and any
collection agency or legal counsel under its direction to contact any school which I attend or have attended to obtain
information concerning my student status, year of matriculation, classification, dates of attendance, date of
graduation or withdrawal, name(s) of other school(s) I may have attended, and my current address. I further
authorize <<University Campus Name>> to obtain my current address from local, state, or federal agencies.
6. By accepting this loan my eligibility for other forms of student financial assistance may be reduced at this campus
of <<University Campus Name>>. Funds received under this loan are to be used solely for educational expenses at
this campus of <<University Campus Name>>.
7. I must report any of the following changes to the Business/Loan Office of the campus from which this loan was
received if:
a) My name, address, telephone number, or social security number changes b) I become entitled to any deferment or
cancellation of my loan c) my graduation date changes
8. Payments should be made payable to “<<Campus University Name>>”. All payments and correspondence should be
mailed directly to
Campus Partners,
P.O. Box 1810,
Winston-Salem, NC 27102
or the Campus Business/Loan Office where I attended.
9. No charges will be deducted from or collected by <<University Campus Name>> at or prior to the disbursement
of my loan.
YOUR LOAN IS A SERIOUS LEGAL OBLIGATION.
If you feel that any information provided in this document is inaccurate or out-of-date, you
should print a copy of the document, make the necessary corrections, sign and return it to:
<<Address Line 1>>
<<Address Line 2>>
<<City/ State>><< Zip>>
I understand that the Total Loan Indebtedness Disclosure presented to me will serve as an itemization of the
amount financed to date.
I have received/printed a copy of this statement.
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DEMO UNIVERSITY
AWARD YEAR: YYYY
06/03/2016
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95

iPROMise - Campus Partners

Transcription

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