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Master Promissory Note
William D. Ford Federal Direct Loan Program
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form shall be subject to penalties which may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C 1097
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OMB No. 1845-0007
Form Approved
Exp. Date 10/31/2005 |
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Federal Direct Stafford/Ford Loan
Federal Direct Unsubsidized Stafford/Ford Loan |
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SECTION A: BORROWER INFORMATION
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READ THE INSTRUCTIONS BEFORE COMPLETING THIS SECTION
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1. Driver's License State and No.
CO
03-038-0748
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2. Social Security No.
222-78-1297
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3. E-mail address (optional)
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4. Name and Address
BROWNELL,
KATHERINE
A
3035 O'NEAL PKY APT. S-34
BOULDER,
CO
80301
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5. Date of Birth
07/01/1986
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6. Area Code/Telephone No.
(303)
247-0720
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7. References: You must list two persons with different U.S.
addresses who have known you for at least three years. The first reference should be a
parent or legal guardian.
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Name
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1.
CAROL
N
OLIVER
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2.
MARCIA
N
BIKALES
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Permanent Street Address
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1650 38TH STREET SUITE 205W
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155 EAST 38TH ST.
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City, State, Zip Code
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BOULDER,
CO
80301
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NEW YORK,
NY
10016
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Area Code/Telephone No.
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(303)
442-6907
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(212)
697-1311
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Relationship to Borrower
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EMPLOYER
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AUNT
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SECTION B: SCHOOL INFORMATION
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8. School Name and Address
COLORADO STATE UNIVERSITY
102 ADMINISTRATION BUILDING
FORT COLLINS,
CO
80523-0100
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9. School Code/Branch
G01350
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10. Identification No.
222781297-M-04-G01350-001
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SECTION C: BORROWER REQUEST, CERTIFICATIONS, AUTHORIZATIONS, AND UNDERSTANDING
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READ CAREFULLY BEFORE SIGNING BELOW
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11. |
This is a Master Promissory Note (MPN) for one or more Federal Direct Stafford/Ford
(Direct Subsidized) Loans and/or Federal Direct Unsubsidized Stafford/Ford (Direct Unsubsidized) Loans.
I request a total amount of Direct Subsidized Loans and/or Direct Unsubsidized Loans under this MPN not
to exceed the allowable maximums under the Act ("the Act" is defined in Section E under Governing Law).
My school will notify me of the loan type and loan amount that I am eligible to receive. I may cancel
a loan or request a lower amount by contacting my school. Additional information about my right to cancel
a loan or request a lower amount is included in the accompanying document called "Borrower’s Rights and
Responsibilities Statement" and in the disclosure statements that will be provided to me.
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12. |
Under penalty of perjury, I certify that:
- The information I have provided on this MPN and as updated by me from time to time is true, complete,
and correct to the best of my knowledge and belief and is made in good faith.
- I will use the proceeds of loans made under this MPN for authorized educational expenses that I incur
and I will immediately repay any loan proceeds that cannot be attributed to educational expenses for attendance
on at least a half-time basis at the school that certified my loan eligibility.
- I do not owe an overpayment on a Federal Pell Grant, Federal Supplemental Educational Opportunity Grant,
or a Leveraging Educational Assistance Partnership Grant (formerly State Student Incentive Grant) or, if I
owe an overpayment, I have made satisfactory repayment arrangements.
- I am not now in default on any loan received under the Federal Perkins Loan Program (including National
Direct Student Loans), the William D. Ford Federal Direct Loan (Direct Loan) Program, or the Federal Family
Education Loan (FFEL) Program or, if I am in default on a loan, I have made satisfactory repayment arrangements.
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13. |
For each Direct Subsidized Loan and Direct Unsubsidized Loan I receive under this MPN,
I make the following authorizations:
- I authorize my school to certify my eligibility for the loan.
- I authorize my school to credit my loan proceeds to my student account at the school.
- I authorize my school to pay to the U.S. Department of Education (ED) any refund that may be due up to
the full amount of the loan.
- I authorize ED to investigate my credit record and report information about my loan status to persons
and organizations permitted by law to receive that information.
- Unless I notify ED differently, I authorize ED to defer repayment of principal on my loan while I am
enrolled at least half-time at an eligible school.
- I authorize my school and ED to release information about my loan to the references on the loan and to
members of my immediate family, unless I submit written directions otherwise.
- I authorize my schools, lenders, guarantors, ED, and their agents to release information about my loan to each other.
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14. |
I will be given the opportunity to pay the interest that ED charges during grace, in-school,
deferment, forbearance, and other periods as provided under the Act. Unless I pay the interest, I understand
that ED may add unpaid interest that is charged on each loan made under this MPN to the principal balance of
that loan (this is called "capitalization") at the end of the grace, deferment, forbearance, or other period.
Capitalization will increase the principal balance on my loan and the total amount of interest I must pay.
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SECTION D: PROMISE TO PAY |
15. |
I promise to pay to ED all loan amounts disbursed under the terms of this MPN, plus interest
and other charges and fees that may become due as provided in this MPN. I understand that more
than one loan may be made to me under this MPN. I understand that by accepting any disbursement issued at any time
under this MPN, I agree to repay the loan associated with that disbursement. I understand that, within certain timeframes,
I may cancel or reduce the amount of a loan by refusing to accept or by returning all or a portion of any disbursement that
is issued. Unless I make interest payments, interest that ED charges on my loans during grace, in-school, deferment,
forbearance, and other periods will be added to the principal balance of the loan as provided under the Act. If I do not
make a payment on a loan made under this MPN when it is due, I will also pay reasonable collection costs, including but
not limited to attorney's fees, court costs, and other fees. I will not sign this MPN before reading the entire MPN,
even if I am told not to read it, or told that I am not required to read it. I am entitled to an exact copy of this MPN
and the Borrower's Rights and Responsibilities Statement. My signature certifies that I have read, understand, and agree
to the terms and conditions of this MPN, including the Borrower Request, Certifications, Authorizations, and Understanding
in Section C, the Notice About Subsequent Loans Made Under this MPN in Section E, and the terms and conditions described
in Section E of this MPN and in the accompanying Borrower's Rights and Responsibilities Statement.
I UNDERSTAND THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS MPN, AND THAT
I MUST REPAY ALL LOANS THAT I RECEIVE UNDER THIS MPN.
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16. |
Borrower's Signature:
Katherine A Brownell
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17. |
Today's Date: (Month/Day/Year)
03/03/2004
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(Electronic Signature) |
SECTION E: MPN TERMS AND CONDITIONS |
GOVERNING LAW
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The terms of this Master Promissory Note (MPN) will be interpreted in accordance with the Higher Education
Act of 1965, as amended (20 U.S.C. 1070 et seq.), and other applicable
federal laws and regulations (collectively referred to as the "Act"). Applicable state law, except as preempted by federal
law, may provide for certain borrower rights, remedies, and defenses in addition to those stated in this MPN.
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DISCLOSURE OF LOAN TERMS
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This MPN applies to Federal Direct Stafford/Ford (Direct Subsidized) Loans and Federal Direct Unsubsidized
Stafford/Ford (Direct Unsubsidized) Loans. Under this MPN, the principal amount that I owe, and am required to repay,
will be the sum of all disbursements that are made (unless I reduce or cancel any disbursements as explained below under
Loan Cancellation), plus any unpaid interest that is capitalized and added to the principal amount.
At or before the time of the first disbursement of each loan, a disclosure statement will be sent to me
identifying the amount of the loan and additional terms of the loan. Important additional information is also contained in
the Borrower's Rights and Responsibilities Statement accompanying this MPN. The Borrower's Rights and Responsibilities
Statement and any disclosure statement I receive in connection with any loan under this MPN are hereby incorporated into this MPN.
Loans disbursed under this MPN are subject to the annual and aggregate loan limits specified under the Act.
I may request additional loan funds to pay for my educational costs up to the annual and aggregate loan limits by contacting
my school's financial aid office. My school will determine if I am eligible for any additional loan funds. I will be notified
of any increase or other change in the amount of my loan.
My eligibility for Direct Subsidized Loans and Direct Unsubsidized Loans may increase or decrease based
on changes in my financial circumstances. My school will notify me of any changes in my eligibility. I will be notified of
any increase or decrease in the amount of my loan.
I understand that each loan made under this MPN is separately enforceable based on a true and exact copy
of this MPN.
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LOAN CANCELLATION |
I may pay back all or part of a disbursement within the timeframes set by the Act, as explained in the Borrower's Rights
and Responsibilities Statement and in a disclosure statement that I will receive. If I return the full loan amount within
those timeframes, I will not incur any loan fee or interest charges. If I return part of a disbursement within those
timeframes, the loan fee and interest charges will be reduced in proportion to the amount returned.
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INTEREST |
Unless the U.S. Department of Education (ED) notifies me in writing of a lower rate, the interest rate
for any loan I receive under this MPN is determined using a formula specified in the Act. As explained in the Borrower's
Rights and Responsibilities Statement, I will be notified of the actual interest rate for each loan that I receive.
ED does not charge interest on a Direct Subsidized Loan during an in-school, grace, or deferment period.
ED charges interest on a Direct Subsidized Loan during all other periods (including forbearance periods), starting on the
day after my grace period ends. ED charges interest on a Direct Unsubsidized Loan during all periods (including in-school,
grace, deferment, and forbearance periods), starting on the date of the first disbursement. I agree to pay all interest
that is charged to me. I will be given the opportunity to pay the interest that accrues during grace, in-school, deferment,
forbearance, or other periods as provided under the Act. If I do not pay the interest, I understand that ED may capitalize the interest at the end of the grace,
deferment, forbearance, or other period
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LOAN FEE |
A loan fee is charged for each Direct Subsidized Loan and Direct Unsubsidized Loan as provided by the Act,
and will be deducted proportionately from each disbursement of each of my loans. The loan fee will be shown on disclosure
statements that will be issued to me. I understand the loan fee may be refundable only as permitted by the Act.
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LATE CHARGES AND COLLECTION COSTS |
ED may collect from me: (1) a late charge for each late installment payment if I fail to make any part
of a required installment payment within 30 days after it becomes due, and (2) any other charges and fees that are
permitted by the Act related to the collection of my loans. If I default on my loans, I will pay reasonable collection costs, plus court costs and attorney fees.
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GRACE PERIOD |
I will receive a six-month grace period on repayment of each loan made under this MPN. The six-month grace period begins the day after I cease to be enrolled at least half-time at an eligible school. I am not required to make any payments on my loan during the grace period. However, interest will accrue on my Direct Unsubsidized Loan and will be capitalized if I do not repay it.
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REPAYMENT |
I must repay the full amount of the loans made under this MPN, including interest that ED charges to me. I will repay each loan in monthly installments during a repayment period that begins on the day immediately following the end of my grace period on that loan. Payments made by me or on my behalf will be applied first to late charges and collection costs that are due, then to interest that has not been paid, and finally to the principal amount of the loan.
The Direct Loan Servicing Center will provide me with a choice of repayment plans. Information on these repayment plans is included in the Borrower's Rights and Responsibilities Statement.
The Direct Loan Servicing Center will provide me with a repayment schedule that identifies my payment amounts and due dates. If I am unable to make my scheduled loan payments, ED may allow me to temporarily stop making payments, reduce my payment amount, or extend the time for making payments, as long as I intend to repay my loan. Allowing me to temporarily delay or reduce loan payments is called forbearance.
I agree that ED may adjust payment dates on my loans or may grant me forbearance to eliminate a delinquency that remains even though I am making scheduled installment payments.
I may prepay all or any part of the unpaid balance on my loans at any time without penalty. If I do not specify which loans I am prepaying, ED will determine how to apply the prepayment in accordance with the Act. After I have repaid in full a loan made under this MPN, ED will send me a letter telling me that I have paid off my loan.
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ACCELERATION AND DEFAULT |
At ED's option, the entire unpaid balance of a loan made under this MPN will become immediately due and payable (this is called "acceleration") if any one of the following events occurs: (1) I fail to enroll as at least a half-time student at the school that certified my loan eligibility; (2) I fail to use the proceeds of the loan solely for my educational expenses; (3) I make a false representation that results in my receiving a loan for which I am not eligible; or (4) I default on the loan.
The following events will constitute a default on my loan: (1) I fail to pay the entire unpaid balance of the loan after ED has exercised its option under items (1), (2), and (3) in the preceding paragraph; (2) I fail to make installment payments when due, provided my failure has persisted for at least 270 days; or (3) I fail to comply with other terms of the loan, and ED reasonably concludes that I no longer intend to honor my repayment obligation. If I default, ED may capitalize all the outstanding interest into a new principal balance, and collection costs will become immediately due and payable.
If I default, the default will be reported to national credit bureaus and will significantly and adversely affect my credit history. I understand that a default will have additional adverse consequences to me as disclosed in the Borrower's Rights and Responsibilities Statement. I also understand that if I default ED may require me to repay the defaulted loan under an income contingent repayment plan.
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LEGAL NOTICES |
Any notice required to be given to me will be effective if mailed by first class mail to the most recent address ED has for me. I will immediately notify ED of a change of address or status as specified in the Borrower's Rights and Responsibilities Statement.
If ED fails to enforce or insist on compliance with any term on this MPN, this does not waive any right of ED. No provision of this MPN may be modified or waived except in writing by ED. If any provision of this MPN is determined to be unenforceable, the remaining provisions will remain in force.
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NOTICE ABOUT SUBSEQUENT LOANS MADE UNDER THIS MPN
This MPN authorizes ED to disburse multiple loans to me to pay my educational expenses during the multi-year term of this MPN, upon my request and upon my school's annual certification of my loan eligibility.
At any school, subsequent loans may be made under this MPN for the same academic year. At schools designated by ED, subsequent loans may also be made under this MPN for subsequent academic years.
I understand that no subsequent loans will be made under this MPN after the earliest of the following dates: (1) the date ED or my school receives my written notice that no further loans may be made; (2) one year after the date I sign the MPN or the date ED receives the MPN if no disbursements are made under the MPN; or (3) ten years after the date I sign the MPN or the date ED receives the MPN.
Any amendment to the Act governs the terms of any loan disbursed on or after the effective date of the amendment, and any amended terms are considered part of this MPN.
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SECTION F: IMPORTANT NOTICES |
GRAMM-LEACH-BLILEY ACT NOTICE
In 1999, Congress enacted the Gramm-Leach-Bliley Act (Public Law 106-102). This Act requires that lenders provide certain information to their customers regarding the collection and use of nonpublic personal information.
We disclose nonpublic personal information to third parties only as necessary to process and service your loan and as permitted by the Privacy Act of 1974. See the Privacy Act Notice below. We do not sell or otherwise make available any information about you to any third parties for marketing purposes.
We protect the security and confidentiality of nonpublic personal information by implementing the following policies and practices. All physical access to the sites where nonpublic personal information is maintained is controlled and monitored by security personnel. Our computer systems offer a high degree of resistance to tampering and circumvention. These systems limit data access to our staff and contract staff on a "need-to-know" basis, and control individual users' ability to access and alter records within the systems. All users of these systems are given a unique user ID with personal identifiers. All interactions by individual users with the systems are recorded.
PRIVACY ACT NOTICE
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:
The authority for collecting the requested information from and about you is §451 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1087a et seq.) and the authority for collecting and using your Social Security Number (SSN) is §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)). Participating in the William D. Ford Federal Direct Loan (Direct Loan) Program and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan (such as a deferment, forbearance, discharge, or forgiveness) under the Direct Loan Program, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect on your loan(s) if your loan(s) become delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information electronically.
The information in your file may be disclosed to third parties as authorized under routine uses in the appropriate systems of records. The routine uses of this information include its disclosure to federal, state, or local agencies, to other federal agencies under computer matching programs, to agencies that we authorize to assist us in administering our loan programs, to private parties such as relatives, present and former employers, business and personal associates, to credit bureau organizations, to financial and educational institutions, to guaranty agencies, and to contractors in order to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to counsel you in repayment efforts, to enforce the terms of the loan(s), to investigate possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in
your loan payments or if you default, to provide default rate calculations, to provide financial aid history information, to assist program administrators with tracking refunds and cancellations, or to provide a standardized method for educational institutions efficiently to submit student enrollment status.
In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization recognized under 5 U.S.C. Chapter 71. Disclosures may also be made to qualified researchers under Privacy Act safeguards.
FINANCIAL PRIVACY ACT NOTICE
Under the Right to Financial Privacy Act of 1978 (12 U.S.C. 3401-3421), ED will have access to financial records in your student loan file maintained in compliance with the administration of the Direct Loan Program.
PAPERWORK REDUCTION NOTICE
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. The valid OMB control number for this information collection is 1845-0007. The time required to complete this information collection is estimated to average 0.5 hours (30 minutes) per response, including the time to review instructions, search existing data sources, gather and maintain the data needed, and complete and review the information. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving the form, please write to: U.S. Department of Education, Washington, DC 20202-4651. If you have any comments or concerns regarding the status of your individual submission of this form, write directly to:
U.S. Department of Education
Common Origination and Disbursement School Relations Center
Attn: Applicant Services
PO Box 9002
Niagara Falls, NY 14302
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TRANSACTION HISTORY |
Below is a summary of the actions that you completed during the electronic Master Promissory Note (MPN) process: |
Your identity was confirmed by the PIN web site on |
03/03/2004 at 17:24:12 CT |
You agreed to use an electronic MPN on |
03/03/2004 at 18:24:45 ET |
You confirmed that you read, understood, and agreed to the Borrower's Rights and Responsibilities Statement on |
03/03/2004 at 18:26:33 ET |
You reviewed your draft MPN and confirmed that you read, understood, and agreed to the Borrower Request, Certifications, Authorizations, and Understanding, Promise to Pay, MPN Terms and Conditions, and Important Notices on |
03/03/2004 at 18:32:30 ET |
You signed your MPN on |
03/03/2004 at 18:32:49 ET |
You reviewed your signed MPN and entered your Confirmation Code on |
To Be Completed |
You confirmed your acceptance of the terms and conditions of this MPN and submitted it to us on |
To Be Completed |
Your MPN Confirmation Code is: 3CB |
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