iPROMise - Campus Partners

Transcription

iPROMise - Campus Partners
7/21/2014
iPROMise
iPROMise User Guide
CAMPUS PARTNERS
Campus Partners
Table of Contents
Overview................................................................................................................................................................................. 3
Borrower Notification ........................................................................................................................................................ 3
iPROMise for Students and Borrowers – Welcome ........................................................................................................ 4
First Time Borrower Page ................................................................................................................................................. 5
Borrower/Student Registration ........................................................................................................................................ 5
Registration – Borrower/Student Identity Verification ................................................................................................... 7
Registration Confirmation Page ....................................................................................................................................... 8
Welcome Page (Home Page) ............................................................................................................................................ 9
Entrance Counseling....................................................................................................................................................... 10
Loan Interview................................................................................................................................................................. 13
STAN Authentication Page.............................................................................................................................................. 27
The Total Loan Indebtedness Disclosure (TLID) ........................................................................................................... 31
Cancelled Awards ........................................................................................................................................................... 35
Deleted Awards ............................................................................................................................................................... 36
Unregistered Borrower/Single Award ............................................................................................................................ 37
iPROMise Login ................................................................................................................................................................... 38
Invalid Login Message .................................................................................................................................................... 39
Get My User ID/Password .............................................................................................................................................. 40
Retrieve ID and Password-Security Question ................................................................................................................ 41
Appendix .............................................................................................................................................................................. 43
Federal Perkins Award File Data Fields ......................................................................................................................... 43
Borrower Notification Email ........................................................................................................................................... 44
HPSL/LDS Multi-Year MPN............................................................................................................................................. 45
HPSL/LDS Single Year MPN ........................................................................................................................................... 48
Institutional Multi-Year ................................................................................................................................................... 51
Institutional Single Year ................................................................................................................................................. 53
NSL Multi-Year ................................................................................................................................................................ 55
NSL Single-Year .............................................................................................................................................................. 58
PCL Multi-Year ................................................................................................................................................................. 61
PCL Single-Year ............................................................................................................................................................... 65
Federal Perkins Loan Master Promissory Note ............................................................................................................. 69
HPSL, LDS, PCL, NSL Total Loan Indebtedness Disclosure ......................................................................................... 73
INST TLID ......................................................................................................................................................................... 75
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Overview
Campus Partners’ iPROMise service supports customers during the financial aid process.
This service allows schools to provide Campus Partners with a data file containing financial
aid awards to existing and incoming students. Customers may choose the level of service
they want for their borrowers to experience. The complete service includes:
• Entrance Counseling – A series of 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 esignature or mail request for a wet signature. This document may also be declined.
• Total Loan Indebtedness Disclosure (TLID) – Presented to the borrower by loan type
and contains the total award amount to date. This document can be accepted, mail
requested, or declined.
Each level of service is explained in more detail in the following pages of this
documentation.
Borrower Notification
Customers may elect to have Campus Partners notify their students when their award is
ready for viewing. Their borrowers can be notified via email, letter, or both. A sample of the
text can be found on page 44 of this documentation.
After notification, students can then access the iPROMise website. Registration is required
before the borrower can complete their Entrance Counseling session and Loan Interview,
electronically sign the Master Promissory Note (MPN) or accept the Total Loan Indebtedness
Disclosure (TLID). Students who do not want to sign the MPN electronically can print their
MPN from their computer or request a hardcopy of the MPN and TLID through mail.
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iPROMise for Students and Borrowers – Welcome
The student enters the Web site by selecting the Enter here link at the bottom of the
Welcome page.
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First Time Borrower Page
In order to comply with specific requirements of the Electronic Signatures in Global National
Commerce Act (“E-SIGN”) (Public Law 106-229), the student will also be provided with the
specific hardware and software requirements necessary to access and participate in
electronic records. The student must affirm their equipment meets the minimum standards
in order to proceed.
If a borrower has previously registered, then the Skip to Login link may be selected.
If the borrower selects Continue after choosing their state and school and affirming that
their hardware and software can support iPROMise, the Borrower/Student Registration page
appears. If Exit is selected, the borrower will be returned to the Welcome page.
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Borrower/Student Registration
This page prompts the borrower/student to provide their required Social Security Number,
the first three letters of their last name, and their date of birth.
*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 information.
NEW FEATURE
A calendar will
appear for any field
that requires a date
entry
Based on the information provided, the student’s award information will be located and the
Borrower/Student Identity Verification page will be presented when the borrower selects the
Register button.
When Exit is selected, the First Time Borrower page will appear.
The Login link located on this page may be used to proceed directly to login.
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Registration – Borrower/Student Identity Verification
The borrower must confirm their identity by clicking beside the statement beginning ‘I
certify...,’ select a secret question, and supply the answer.
When each item is completed and Submit is selected, the registration information will be
processed. A user ID and Password will be created and provided on the Registration
Confirmation page.
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If the Borrower selects ‘This is not my information’ from the Borrower/Student Identity
Verification page, then a pop-up box (illustrated below) will be displayed. If OK is selected
the borrower/student will be redirected to the Registration Page to re-enter his or her
information and to try again.
Registration Confirmation Page
At this point, the student/borrower has become a registered user of iPROMise. The
borrower/student should click Go to Login at this time. After log in, the borrower/student will
be presented with the Home page that displays links (based on customer options) to
Entrance Counseling and Loan Interview, which must be completed before the MPN or TruthIn-Lending Disclosure will be presented.
Alternatively, they may Exit at this time, return to the site later to login, and 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 (referred to as Home page from this
point forward). Each section of the Home page is described below.
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Entrance Counseling
To start this section, the borrower should click on the Requires Completion link from the
home page. A welcome page will be presented with the school name located at the top of
the screen.
Entrance Counseling-Questions and Answers
Entrance counseling consists of sections of text based on loan type followed immediately by
a multiple choice question/answer. After reading the question, the borrower should select
his or her answer and click the Submit button at the bottom of the page. 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 a Federal Perkins text and
question/answer is on the following page.
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NEW FEATURE
A road map for the
number of questions
now displays to the
user.
If the student selects the Cancel button located at the bottom of this screen at any time
during this section, it will return the student to the home page and NO information will be
saved for the Entrance Counseling portion. The section will be marked with Requires
Completion.
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Incorrect Responses
An incorrect response to a question will result in a message at the bottom of the current
page in red as shown below. The user will have an opportunity to correct their response and
continue.
Correct Responses
When the borrower has correctly responded to all questions, the Entrance Counseling
session is completed. The borrower receives a Congratulations page.
Clicking the Continue button will take the borrower back to the Home Page where the
Entrance Counseling section will be marked as “Completed.” Clicking the Cancel button will
also take the borrower back to the Home Page.
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Loan Interview
From the home page, the borrower should select Requires Completion located under Loan
Interview.
The Loan Interview page will appear:
Clicking the Cancel button will return the borrower to the Home Page. Choosing Continue will
display page one of the Loan Interview data fields. The Loan Interview pages require the
borrower to enter personal and demographic information and are the same for all loan
types. At this time a separate interview must be completed for all awards that have been
loaded to the site for the borrower.
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Loan Interview – Page 1
Cancel
The Cancel button
will return the
borrower to the
Home page.
Data fields included on this page:
 Name – This field is not updateable by the borrower
 SSN – This field is not updateable by the borrower
 Major*
 Local Address* – Includes Address Line 1, City, State, Zip Code, Phone Number, and
Cell Phone Number
 Permanent Address (*if different) – Includes Address Line 1 and 2, City, State, Zip
Code, and Phone Number
 Email Address
 Student ID
 Expected Grad Date – This field is not updateable by the borrower
 Driver’s License Number
 State of Issue of DL
 Date of Birth – This field is not updateable by the borrower
*Indicates Required Field (must be populated before going to the next page)
Bold items are pre-populated from the Award File if provided.
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Clicking the Continue button from the Loan Interview page 1 will display page 2 of the Loan
Interview.
Loan Interview – Page 2
Data fields included on this page:
• Plans for Two Years Beyond Graduation*
• Employer’s Name*
• Employer’s Street Address, City, State, Zip Code, and Phone Number*
• Fraternity or Sorority
• Spouse’s Name
• Spouse’s SSN
• Spouse’s Employer, Street Address, City, State, Zip Code, and Work Phone Number
*Indicates Required Field (must be populated before going to the next page). (If the borrower is unemployed,
the “I acknowledge that…” box may be checked and the Employer Information will no longer be a required
field.)
Clicking the Continue button from Loan Interview page 2 will display page 3 of the Loan
Interview. The Cancel button react in the same manner for page 2 as it did for page 1.
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Loan Interview – Page 3
Data fields included on this page:
• Banks
• City, State, and Zip Code
• Account No.
• Father, Stepfather, Guardian, or Next of Kin*
• Father, Stepfather, or Next of Kin Address (Line 1), City, State, Zip Code, Phone
Number
• Father, Stepfather, or Next of Kin Employer
• Mother, Stepmother, Guardian, or Next of Kin*
• Mother, Stepmother, Guardian, or Next of Kin Address (Line 1), City, State, Zip Code,
Phone Number*
• Mother, Stepmother, or Next of Kin Employer
*Indicates Required Field (must be populated before going to the next page)
Clicking the Continue button from Loan Interview page 3 will display page 4 of the Loan
Interview. The Cancel button will react in the same manner for page 3 as it did for page 1.
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Loan Interview – Page 4
Data fields on the previous page include:
• Reference Information (2)*
Name
Address (Line 1), City, State, Zip Code, Phone Number
• Reference Employer Information
Employer Name
Address (Line 1), City, State, Zip Code, Phone Number
*Indicates Required Field (must be populated before going to the next page)
The Cancel button will react in the same manner for page 4 as they did for page 1.
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New Feature
When a user adjusts their web
browser, the boxes within the website
will adjust to provide a “best fit.”
Here, by shrinking the web browser
laterally, the Second Reference box
moved below the First Reference box
(in a normal size view, the two boxes
are side-by-side as shown above.
Note: If a student clicks Continue from any page of the interview section and required
field(s) are not completed, then messages 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 5
Data fields on the previous page include:
• Relative Information (2) *
Name
Address (Line 1), City, State, Zip Code, Phone Number
• Relative Employer Information
Name
Address (Line 1), City, State, Zip Code, Phone Number
*Indicates Required Field (must be populated before going to the next page)
If Continue is clicked on page 5 and all information is complete, then the Loan InterviewThank You page will be displayed.
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Loan Interview-Thank You
If the Cancel button is selected, the borrower will be returned to the Welcome Page. If
Return To Home is selected, the borrower will be returned to the Home Page and the loan
interview section will be marked “Completed” as shown below.
From this page, the borrower can log out and complete the session at a later time, or select
the Requires Completion link under MPN.
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The Master Promissory Note – Section 1 – Introduction
If Cancel is chosen, the borrower will be returned to the Home Page.
If the borrower clicks the View Electronic Signing Disclosure Statement button, the following
page will be displayed.
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The Master Promissory Note – Section 2 – 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 what hardware and software are
recommended before proceeding with the e-signature process.
If the Cancel button is clicked, the borrower will be returned to the home page.
The borrower must click the ‘I consent…’ checkbox before clicking the Proceed to the Master
Promissory Note button to proceed to the following page.
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The Master Promissory Note – View PDF
This page displays a PDF image of the Master Promissory Note for the loan type indicated by
the Award File. The student can click the image itself to view the MPN. The MPN is opened in
the same window as shown on the next page.
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MPN – View in Same Window
The document can be closed by clicking the Back arrow, which will return the borrower to
the Master Promissory Note-View PDF screen.
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 if a note is displayed or not 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…’ The Sign Electronically and Sign By Mail buttons will then become available.
If 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 address for mailing the MPN to other 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 the Back arrow is selected, the borrower will be
returned to the View PDF page. If 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.
The Return to Home button will take the borrower to the Home Page. The MPN and TLID
column of the home page will indicate Mailed.
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If the borrower logs in later and selects the MPN link labeled as Mailed (from the home
page) in order to view or e-sign the MPN, the following message will display on the View PDF
page:
The borrower can choose to electronically sign the document by clicking the Sign
Electronically button or decline the document. (See Sign Electronically section.)
Sign Electronically – Accept Award
If the Sign Electronically button is clicked from the View PDF page, the following page
appears:
The borrower can accept the award by clicking the I Accept the Award As Shown button. The
STAN Authentication page will be displayed.
If the I Decline the Award button is clicked, a page will appear informing the borrower that
he has declined the award and that his school will be notified. 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.
The Cancel button will display the Home page.
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STAN Authentication Page
This page informs the borrower that if the Submit button is selected, he/she will be
forwarded to an external site where the e-signature authentication process will take place,
and then he/she that they will be returned to the iPROMise site for confirmation of
signature.
The Cancel button will display the home page. The Submit button will display the Student
Authentication Network page.
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. Reset will clear the page so that the
information can be re-entered. Clicking the Submit button will display a security warning.
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Successful STAN Authentication
The following web 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 clicking the
Confirm Signature button. The Back arrow will return the borrower to the beginning of
Section 4 where they accept or decline the award. If the borrower clicks the Confirm
Signature button, the electronic signature is applied and the status of the MPN on the Home
page changes to E-Signed.
Note: ESigning the MPN does not change the status of the TLID. After returning to the Home
Page, the borrower should click the TLID link to view, accept, mail, or decline the TLID.
Confirmed Signature
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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 click the E-Signed link. The MPN will again
open in the same window.
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To print the MPN, File should be selected from the toolbar located at the top of the screen
and then Print (or the Printer icon appears at the bottom of some web browsers). The MPN
will be printed on the borrower’s printer. 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 nonPerkins loan.
The 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 four digit
number assigned by the STAN site).
Once the borrower has completed the printing or viewing process, he may return to the
Home page by clicking on the Back arrow. The borrower can proceed to the Total Loan
Indebtedness Disclosure by clicking the link located under the TLID link.
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The Total Loan Indebtedness Disclosure (TLID)
The link located under the TLID column can display different statuses (Mailed, Accepted, or
Declined). Since some of these statuses are dependent on the action taken on the MPN,
this section will describe the borrower experience based on the status possibilities for the
TLID.
1. Signed MPN/TLID Requires Completion
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. The following page will be presented:
Before viewing the TLID, the borrower must click the checkbox beginning ‘I consent…’
located above the image. Once this is done, the document can be viewed by clicking on the
document itself – a PDF link will be provided to download and view the document.
To accept or request a copy to be mailed, the borrower must click the checkbox with the
statement beginning ‘I acknowledge…’. The accept and mail options below will become
available. If the borrower chooses to Decline the TLID they can check the box marked
Decline the Award without checking any consent or acknowledge statements.
If Accept the award as shown button is clicked, the following page will be presented:
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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.
If the borrower chooses Have copy of TLID mailed to me from the view pdf page, the
following page will be displayed:
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The borrower can indicate (if he chooses to) 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 address. Clicking the Submit button will display a
Thank You page as well. If the Back arrow is selected, the borrower will be returned to the
View PDF page.
If the Decline the award button is clicked from the view pdf page, then a Thank You page will
be presented similar to the one shown in Figure 38 but will contain text appropriate for the
Decline transaction.
2. MPN mailed/TLID mailed
If the borrower requests that the MPN be mailed, the status for the TLID will be updated to
Mailed as well. The Home Page will display the TLID link as Mailed. The borrower can
immediately, or in a later session, view or print the TLID by clicking the mailed link from the
Home Page. The following page will be displayed. If the borrower wants to accept or decline
the TLID, he must first e-sign or decline the MPN. At this point, the mail option for the TLID is
no longer available to the borrower without acting on the MPN first.
The Cancel button will return the borrower to the Home page.
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3. MPN Declined/TLID Declined
If the borrower has declined the MPN, the status for the TLID will be updated to Declined.
The Home page will display Declined under both the MPN and TLID columns. The borrower
can no longer access either document.
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 only unless
otherwise noted.






















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, 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. A Home page for a borrower
with a cancelled 2008 award is shown below.
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Deleted Awards
Registered Borrower/Single Award
If a borrower’s school deletes the only award for a borrower and the borrower has previously
registered on the site, the following message will be displayed on the login page when 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.
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 ID and password created at registration to:




Log-in to iPROMise
Complete their Loan Interview
Sign the MPN
View/print the Truth-in-Lending/TLID document and MPN
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Invalid Login Message
If the User ID or password entered is invalid, then the following message will be displayed:
The borrower should re-enter their User ID and/or password and try again. If they have
forgotten either their User ID or password, then he/she should click the Get My User
ID/Password link.
Clicking the Exit button from this page will return the borrower to the Welcome 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, then the message, Student record not found. Please try
again will be displayed. The borrower will be given another chance to enter the correct
information.
Clicking the Cancel button will return the borrower to the Welcome page.
Once the correct information is provided and the Submit button is clicked, the borrower will
be presented with the Retrieve User ID/Password Screen.
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Retrieve ID and Password-Security Question
The answer to the security questions selected at Registration will be displayed on this
screen. The borrower should enter the answer to this questions in the space provided. The
borrower must select the correct answer to his question in order to receive his User ID and
password.
The borrower should contact Campus Partners to obtain forgotten answers to security
questions.
If the Cancel button is clicked, then the borrower will be returned to the Welcome page.
Clicking the Submit button will display the following page:
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This page will give the borrower his User ID and Password.
If Go To Login is clicked, the borrower will be required to re-enter his/her password only; the
User ID will be pre-filled. If the Exit button is selected, the site will return the borrower to
Welcome page.
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Appendix
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.
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.
Borrower Telephone–Optional.
Driver’s License Number–Optional.
Driver’s License State–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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29. 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.
30. 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.
31. 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.
32. Fall Award Date-Required field if MPN Indicator = S and a Fall Award amount is
entered. Format YYYYMMDD.
33. Winter Award Date-Required field if MPN Indicator = S and a Winter Award amount is
entered. Format YYYYMMDD.
34. Spring Award Date-Required field if MPN Indicator = S and a Spring Award amount is
entered. Format YYYYMMDD.
35. 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.
Borrower Notification Email
Date: 07/12/2014 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 esign 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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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 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.
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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HPSL/LDS Single 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
SINGLE 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 <<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 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.
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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
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
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.
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
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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.
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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Institutional Multi-Year
<<University Campus Name>>
Multiple Year Master Promissory Note
Section A: Borrower Section
Social Security Number
Last Name, First Name, MI
Address 1
Address 2
City
St
Date of Birth
Zip
Phone Number ( )
Driver’s License 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 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.
Borrower’s Signature_______________________ Date________________________
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Institutional Single Year
<<University Campus Name>>
Multiple Year Master Promissory Note
Section A: Borrower Section
Social Security Number
Last Name, First Name, MI
Address 1
Address 2
City
St
Date of Birth
Zip
Phone Number ( )
Driver’s License Number
Section B: School Section
University Campus Name
Address 1
Address 2
City
St
Annual Interest Rate:
Repayment Frequency:
Term:
Zip
SCHEDULE OF ADVANCES
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 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.
Borrower’s Signature_______________________ Date________________________
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NSL Multi-Year
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS)
PUBLIC HEALTH SERVICE (PHS)
HEALTH RESOURCES AND SERVICES ADMINISTRATION
BUREAU OF HEALTH PROFESSIONS
GUIDANCE
NURSING STUDENT LOAN PROGRAM
MASTER PROMISSORY NOTE
MULTI-YEAR
FOR LOANS MADE ON OR AFTER
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 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 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.
2. Repayment (Section 836 Public Health Service Act, 42 CFR 57.310):
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.
4. Deferment (Section 836 Public Health Service Act, 42 CFR 57.310): 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; 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.
6. Exit Interview (42 CFR 57.310): The Borrower agrees to attend an exit interview prior to completing or
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.
9. Acceleration (42 CFR 57.308): If the Borrower fails to make a scheduled repayment or fails to comply with any
other terms 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 57.310): 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 (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.
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 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 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.
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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.
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 form as my Master Promissory Note for all loans received under the Nursing Student Loan 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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NSL Single-Year
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS)
PUBLIC HEALTH SERVICE (PHS)
HEALTH RESOURCES AND SERVICES ADMINISTRATION
BUREAU OF HEALTH PROFESSIONS
GUIDANCE
NURSING STUDENT LOAN PROGRAM
MASTER PROMISSORY NOTE
SINGLE YEAR
FOR LOANS MADE ON OR AFTER
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.
SCHEDULE OF ADVANCES
NUMBER
AMOUNT ADVANCED
TOTAL
TO DATE
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 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.
2. Repayment (Section 836 Public Health Service Act, 42 CFR 57.310):
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.
4. Deferment (Section 836 Public Health Service Act, 42 CFR 57.310): 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; 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.
6. Exit Interview (42 CFR 57.310): The Borrower agrees to attend an exit interview prior to completing or
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.
9. Acceleration (42 CFR 57.308): If the Borrower fails to make a scheduled repayment or fails to comply with any
other terms 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 57.310): 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 (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.
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 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
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 form as my Master Promissory Note for all loans received under the Nursing Student
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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PCL Multi-Year
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS)
PUBLIC HEALTH SERVICE (PHS)
HEALTH RESOURCES AND SERVICES ADMINISTRATION
BUREAU OF HEALTH PROFESSIONS
GUIDANCE
PRIMARY CARE LOAN PROGRAM MASTER PROMISSORY NOTE
MULTI -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 <<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.
The Borrower and Institution further understand and agree that:
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 3year 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.
5. 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
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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 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
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 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 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 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.
8. 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.
9. 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.
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.
12. 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, 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.
13. 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.
14. 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
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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.
15. 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.
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.
17. 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 Health Professions Student Loan and Primary
Care Loan programs, 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.
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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.
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 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
Social Security Number
Date of Birth
School Entrance Date
School Exit Date
Borrower Signature_______________________________________
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PCL Single-Year
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES (DHHS)
PUBLIC HEALTH SERVICE (PHS)
HEALTH RESOURCES AND SERVICES ADMINISTRATION
BUREAU OF HEALTH PROFESSIONS
GUIDANCE
PRIMARY CARE LOAN PROGRAM MASTER PROMISSORY NOTE
SINGLE 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 <<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.
SCHEDULE OF ADVANCES
NUMBER
AMOUNT ADVANCED
TOTAL
TO DATE
The Borrower and Institution further understand and agree that:
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 3year 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
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.
5. 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 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
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 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 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 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.
8. 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.
9. 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.
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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12. 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, 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.
13. 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.
14. 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, 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.
15. 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.
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.
17. 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 Health Professions Student Loan and Primary
Care Loan programs, 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.
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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.
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 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
Social Security Number
Date of Birth
School Entrance Date
School Exit Date
Borrower Signature_______________________________________
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Federal Perkins Loan Master Promissory Note
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HPSL, LDS, PCL, NSL Total Loan Indebtedness Disclosure
<<University Campus Name>>
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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INST TLID
<<University Campus Name>>
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
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student records including grades, transcripts and diplomas or make me ineligible to receive any additional financial
aid funds.
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:
<<University Campus Name>>
<<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: 2014
06/30/2015
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