2017-2018 Federal Direct Parent Plus Loan Request Form printable pdf download

2017-2018 Federal Direct Parent PLUS Loan

Request Form

Your student will need to complete the 2017-18 FAFSA in order for you to be eligible to apply for this loan. The parent must pass a

mandatory credit check performed by the Direct Loan Servicing Center. Parents may borrow up to the Cost of Attendance minus

other financial aid. A Parent PLUS master promissory note (MPN) must be completed online at

before the

loan can be disbursed.

Student Name:____________________________________

HC Student ID:______________________

Parent Borrower Information

Parent Borrower Full Name _________________________________________________________________ SSN#_______________

Last

First

Parent Relationship to Student: _____Father _____Mother

_____Step-Father _____Step-Mother

Parent Borrower Address: _____________________________________________________________________________

Street

City

State

Zip Code

Parent Borrower Driver’s License State and Number ________________________________________

State

Number

Parent Borrower Birth Date

Parent Borrower Phone Number

Parent Borrower Email Address

_____________________

__________________________

_________________________

Month

Day

Year

(Area Code) Number

Parent Borrower U.S. Citizenship Status (check the one box that applies):

A.____U.S. citizen or national

B. ____Permanent resident or other eligible alien

C. ____Neither A. nor B.

Alien Registration Number__________________

Issued Date____________

Loan Period Information:

All loans will be evenly disbursed across the terms requested. The student must be enrolled for at least 6 credits hours for each term

applicable to the award. Please indicate all terms for which you want the loan to apply by circling the term:

FALL

SPRING

SUMMER

Loan Amount Information:

Total amount you wish to borrow:

$____________________

After billable expenses are paid, any excess funds that are the result of the PLUS loan are to be refunded to:

______Yes, I would like the refund check made out to me from the excess PLUS loan funds.

______No, I would like the student to receive the refund from the excess PLUS loan funds.

Check ONE option below in the event your Parent PLUS is denied due to the results of the credit check:

_____ Appeal the decision. Information and instructions available on .

_____ Use an endorser (credit-worthy co-signer. They will need their own FSA ID to endorse the loan.)

_____ Allow the Student to be considered for the Additional Federal Direct Unsubsidized Stafford Loan

If I, ___________________________________ am eligible to receive additional unsubsidized loan, I would like to request $_____________

Student’s Signature

(Maximums limited by completed credits: <30 credits: $4000; >30: $5000)

Your signature confirms that you are not in default on a prior loan and authorizes the initiation of the mandatory credit review required for the

Parent PLUS Loan. In addition, the Privacy Act of 1974 (5 U.S.C.552a) requires that the following notice be provided to you. The authority for

collecting the information requested on this form is section 451 et seq. of the Higher Education Act of 1965, as amended. Your disclosure of this

information is voluntary. However, if you do not provide this information, you cannot be considered for a Parent PLUS. The information on this form

will be used to determine your eligibility for a Parent PLUS.

Parent’s Signature: _______________________________________________

Date: _________________

Return Form to the Office of Financial Aid

P.O. Box 308 Notre Dame, IN 46556 ∘

∘ call: 574-239-8408 ∘ fax: 574-239-8324

financialaid@hcc-nd.edu

2017-2018 Federal Direct Parent Plus Loan Request Form

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