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MISSOURI DEPARTMENT OF AGRICULTURE

FORM 2 PAGE 1

1616 MISSOURI BOULEVARD, JEFFERSON CITY, MO 65109

ALL INFORMATION IS CONFIDENTIAL AND

LARGE ANIMAL VETERINARY STUDENT LOAN PROG

RAM

FOR PROGRAMMATIC PURPOSES ONLY

LOAN CONTRACT AND PROMISSORY NOTE

MUST BE TYPED OR PRINTED

ORROWER S NAME

(LAST

, FIRST, MIDDLE INITIAL)

ADDRESS

STREET

TELEPHONE

NUMBER

FAX NUMBER

CITY

STATE

ZIP CODE

BIRTHDATE

SOCIAL SECURITY NO.

APPLYING FOR ACADEMIC YEAR

LENDING INSTITUTION

The Missouri Department of Agriculture

TERMS

I agree to pay the State of Missouri, or its authorized agent, the principal sum of twenty thousand dollars ($20,000), plus interest in United

States currency, upon maturity of this note.

INTEREST

I hereby agree to pay simple interest on the unpaid loan principal at a rate of __________________________________ from the issue

date of the state check until the principal and accumulated interest are paid.

MATURITY

This note will mature when the borrower ceases to be an eligible student in the University of Missouri College of Veterinary Medicine

Program.

FORGIVENESS

Payment of $20,000 principal and accrued interest will be forgiven for each full calendar year that borrower engages in qualified employment,

(defined in Section 340.777) in an area of defined need, (defined in 2 CSR 3011.010) in this state. Qualified employment or financial

repayment must begin within six (6) months after completion of the doctor of veterinary medicine degree.

ADDITIONAL AGREEMENTS

The borrower fully understands and agrees to the following:

1. The borrower will use the proceeds of this loan for educational and/or living expenses.

2. The borrower will send written notice to the Missouri Department of Agriculture within thirty (30) days after any change in enrollment status,

practice location, type of practice, name or address.

3. That the borrower is making a commitment to provide services, upon completion of veterinary training, in an area of defined need as

determined by the Missouri Department of Agriculture.

4. If the borrower’s eligibility status changes (no longer a veterinary student or a veterinary student in good standing) or the borrower is not

providing professional veterinary services in an area of defined need, repayment of the loan principal and interest shall begin with ninety

(90) days of the date the recipient ceases to be an eligible student. Payment shall be completed no more than twelve (12) months from

that date.

5. The borrower will provide verification to the Missouri Department of Agriculture as to their enrollment, program eligibility, and academic

standing within thirty (30) days of the completion of each semester and summer session and their expected program completion date.

6. Upon completion of the DVM program and becoming licensed should the borrower at any time choose not to provide veterinary services

in an area of defined need, repayment of the loan principal and interest becomes due and owing immediately and under a jointly agreed

to repayment program must be completely repaid within one (1) year of the breach.

7. If the borrower violates any of the provisions of this loan contract or promissory note, including notifying the Missouri Department of

Agriculture of change of address, the Missouri Department of Agriculture may call the note due immediately.

8. When necessary to protect the interest of the State in any loan transaction under Section 340.335, RSMo, the Missouri Department of

Agriculture may institute any action to recover any amount owed.

MO 3501464 (309)

AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER

PAGE 1 OF 2

services provided on a nondiscriminatory basis

Loan Contract And Promissory Note

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