FEDERAL PERKINS LOAN MASTER PROMISSORY NOTE
OMB No. 1845-0074 Form Approved Expiration Date 06/30/2006
A: Borrower Section
Name and Permanent Address
|111 Main Street
|Pittsburgh, PA 15108
state abbreviation first)
B: School Section
School Name and Address
111 MAIN STREET
POSTAL DROP 7
MYTOWN, PA 22345
[Any bracketed clause or paragraph may be included at option of institution]
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.
- 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.]
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.
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 and 3 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.
- 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
OF STATUS - I will inform the School of any change in my name, address,
telephone number, Social Security Number, or driver's license number.
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.
THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS MASTER PROMISSORY NOTE AND THAT I
MUST REPAY SUCH LOANS.
|Signature: Maxwell LaSmart (E-signature)
||Date/Time: 01/04/2003 15:50:30
Terms and Conditions (cont.)
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.
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 twelve 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 twelfth consecutive payment. If I default on my rehabilitated loan, the cap
on collection costs is removed.
- 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.
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 low-income
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
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.
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.
- 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 be
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
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
- Upon making a properly documented written 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.
- 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 post-graduate 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; and (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 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.
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
I am not
eligible for a deferment while serving in a medical internship or
Terms and Conditions (cont.)
- 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, B, C, D, and E below. Qualifying service must be performed after
the enrollment period covered by the loan.
Teaching · a full-time teacher in a public or other nonprofit
elementary or secondary school, 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 is published annually by the Department.
· a full-time special education teacher in a public or nonprofit
elementary or secondary school system; 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.
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.
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.
Nurse or Medical Technician · a full-time nurse providing health care
services; or · a full-time medical technician providing health
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
Rates - For each completed year of service under paragraphs A, B, C, D, and E 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 year and fourth years; and · 30 percent of the original
principal loan amount for the fifth year.
Head Start Cancellation - 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 canceled for qualifying service performed after the enrollment
period covered by the loan as: · a full-time staff member in the educational
component of a Head Start program which is operated for a period comparable
to a full School year and which pays a salary comparable to an employee of
a local educational agency.
Rate - For each completed year of service under the Head Start Cancellation
provision, this loan will be canceled at the rate of 15 percent of the original
principal loan amount.
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 performed after the enrollment period covered by
the loan 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.
Rate - For each completed year of service under the Military Cancellation
provision, this loan will be canceled at the rate of 12½ percent of the
original principal loan amount.
Volunteer Service Cancellation - Upon making a properly documented written
request to the School, I am entitled to have up to 70 percent
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).
Rate - For each completed year of service under the Volunteer Service
Cancellation provision, a portion of this loan will be canceled at the
· 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.
- My obligation to repay this loan may be partially or totally discharged for
the reasons specified in paragraphs A, B, C, and D below.
Death - In the event of my death, the School will discharge the total
amount owed on this loan.
Total and Permanent Disability - If I become totally and permanently disabled
after I receive this loan, the School will discharge the total amount owed
on this loan. If my disability discharge claim is approved by the School,
this loan will be assigned to the United States Department of Education, which
will discharge the total amount owed on this loan if it determines that I am
eligible for a total and permanent disability discharge.
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
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.
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.
The Privacy Act
of 1974 (5 U.S.C. 552a) requires that the following notice be provided
for collecting the requested information from and about you is §461 et seq.
of the Higher Education Act of 1965, as amended (20 U.S.C. 1087 aa et seq.) and
the authority for collecting and using your Social Security Number (SSN) is §484(a)(4) of
the HEA (20 U.S.C. 1091(a)(4)). 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.
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 cancellation)
under the Perkins Program, to permit the servicing of your loan(s), and, if
it becomes necessary, to locate you and to collect 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
in your file may be disclosed to third parties as authorized under routine
uses in the appropriate systems of records. The routine uses of this
information include its disclosure to federal, state, or local agencies, to
other federal agencies under computer matching programs, to agencies that we
authorize to assist us in administering our loan programs, to private parties
such as relatives, present and former employers, business and personal
associates, to credit bureau organizations, to educational institutions, and
to contractors 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 counsel you in repayment efforts, to enforce the terms of
the loan(s), to investigate possible fraud and to verify compliance with federal
student financial aid program regulations, to locate you if you become delinquent
in your loan payments or if you default, to provide default rate calculations, to
provide financial aid history information, to assist program administrators
with tracking refunds and cancellations, or to provide a standardized method
for educational institutions efficiently to submit student enrollment status.
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 also be made to qualified researchers under Privacy Act
Privacy Act Notice
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.
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. 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 20202-4651.
If you have
any comments or concerns regarding the status of your individual submission
of this form, write directly to the lender.