Omb No. 1845-0061 Form - Federal Perkins Loan Promissory Note (Page 4 of 4) in pdf

Important Notices

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 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. 10941(a)(4)). Participating in the Federal Perkins

Loan (Perkins) 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 cancellation) under the Perkins 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 educational institutions, 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, 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), the U.S. Department of Education will have access to financial records in your student loan

file maintained by the lender in compliance with the administration of the Federal Perkins 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 1845-0061. The time required to complete this information is estimated to average 0.5

hours (30 minutes) per response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and complete and

review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please

write to:

U.S. Department of Education

Office of Student Financial Assistance

Program Development Division

400 Maryland Avenue, S.W.

(Room 3053, ROB-3)

Washington, DC 20202-5449.

If you have any comments or concerns regarding the status of your individual submission of this form, write directly to the lender.

Page 4 of 4