Fillable Master Promissory Note Template Direct Plus Loans (Page 15 of 15) in pdf

INSTRUCTIONS

MASTER PROMISSORY NOTE FOR DIRECT PLUS LOANS

GENERAL INSTRUCTIONS AND INFORMATION

Item 9. Enter your employer's name and address (number, street, city, state, zip code). If

you are self-employed, enter the name and address of your business. If you are not

Type or print using blue or black ink. Do not use pencil. Enter all dates as

employed, enter N/A.

month-day-year (mm-dd-yyyy). Use only numbers. Example: January 31, 2017

Item 10. Enter your work area code and telephone number. If you are self-employed,

= 01-31-2017.

enter the area code and telephone number of your business.

Throughout the Master Promissory Note (MPN) and the accompanying

REFERENCE INFORMATION

Borrower's Rights and Responsibilities Statement, the words “we,” “us,” “our,”

and “ED” refer to the U.S. Department of Education.

Items 11 and 12. Enter the requested information for two adults with different U.S.

addresses who do not live with you, and who have known you for at least three years

BORROWER INFORMATION

and will know how to contact you in the future. If you are a parent borrower, do not list

Note: Some of the items in this section may have been completed for you. If

the student for whom you are borrowing as a reference. References who live outside the

so, review these items carefully to make sure that the information is correct.

United States are not acceptable. Providing an email address for a reference is optional.

Cross out any information that is incorrect and enter the correct information.

If you provide an email address, we may use it to communicate with the reference. If a

Put your initials next to any information that you change.

reference does not have a telephone number or email address, or does not wish to

provide an email address, enter N/A.

Item 1: Check the appropriate box to indicate whether you are a Graduate or

Professional Student or a Parent of a Dependent Undergraduate Student.

SCHOOL INFORMATION

Item 2. Enter your first name, then your middle initial and last name. Enter

This section will be completed by the school that determines your eligibility to receive

your permanent address (number, street, apartment number, or rural route

the loan.

number and box number, then city, state, zip code). If your mailing address is

DEPENDENT UNDERGRADUATE STUDENT INFORMATION

different from your permanent address, you must list both addresses. A

Complete this section only if you are a parent borrowing for a dependent

temporary school address is not acceptable.

undergraduate student.

Item 3. Enter your nine-digit Social Security Number.

Item 16. Enter the student's first name, then middle initial and last name.

Item 4. Enter your date of birth.

Item 17. Enter the student's nine-digit Social Security Number.

Item 5. Enter the two-letter abbreviation for the state that issued your

Item 18. Enter the student's date of birth.

current driver's license, followed by your driver's license number. If you do

not have a driver's license, enter N/A.

BORROWER REQUEST, CERTIFICATIONS, AUTHORIZATIONS, AND

UNDERSTANDINGS

Item 6. Enter your preferred email address for receiving communications.

Top of Page 2. Enter your name and Social Security Number.

You are not required to provide this information. If you do, we may use your

email address to communicate with you. If you do not have an email address

Items 19, 20, 21, and 22. Read these items carefully.

or do not wish to provide one, enter N/A.

PROMISE TO PAY

Item 7. Enter the area code and telephone number at which you can most

Items 23, 24, 25, and 26. Read these items carefully.

easily be reached. (Do not list your work telephone number here.) If you do

Items 27 and 28. Sign your full legal name, in blue or black ink, and enter the date you

not have a telephone, enter N/A.

signed this MPN. By signing this MPN, you (1) acknowledge that you have read,

Item 8. Complete this item only if you are a parent borrower. Place a

understand, and agree to the terms and conditions of the MPN, including the Borrower

check in the box that corresponds to your citizenship status. If you check box

Request, Certifications, Authorizations, and Understandings and the accompanying

(2), enter your Alien Registration Number.

Borrower's Rights and Responsibilities Statement; and (2) agree to repay in full all loans

(1) “U.S. Citizen” includes citizens of the 50 states, the District of Columbia,

made under this MPN according to the terms and conditions of the MPN.

Puerto Rico, the U.S. Virgin Islands, Guam, and the Northern Mariana Islands.

“National” includes not only all U.S. citizens, but also citizens of American

Samoa and Swain's Island.

(2) “Permanent Resident” means someone who can provide documentation

of this status from the U.S. Citizenship and Immigration Services (USCIS).

“Other Eligible Non-Citizen” includes individuals who can provide

documentation from the USCIS that they are in the United States for a

purpose that is not temporary, with the intention of becoming a citizen or

permanent resident. This category includes refugees, persons granted

asylum, Cuban-Haitian entrants, temporary residents under the Immigration

Reform and Control Act of 1986, and others.

NOTE: If your citizenship status is not one of the categories described

above, you are not eligible to receive a Direct PLUS Loan.

Page 15 of 15

Master Promissory Note Template Direct Plus Loans Page 15

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