Federal Direct Parent Plus Loan Application Form Page 2
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1
2Office of Financial Aid
2802 Moore Highway, Box 23
Tifton, Georgia 31793
Fax: 229-391-4871
Federal Direct Parent PLUS Loan Application
(This is only an application. Federal Direct Loan Program is responsible for final credit approval.)
Student’s ID:
Student Email:
Student Full Legal Name:
(Please print clearly)
(Last)
(First)
(Middle)
Borrower Information: (May only be one parent. Please type or print clearly.)
Parent’s SSN: _________________________________
Parent’s Name: _______________________________________________________________________________
(Last)
(First)
(Middle)
Parent’s Address: ____________________________________________________________________________
Street
City
ST
Zip
Parent’s Birth Date: _____________________________ Home Phone ____________________________
Month/day/year
area code & number
Citizenship Status (check one)
____________________
US Citizen or eligible non-citizen
Non-Citizen
Alien Registration #
Driver’s License #: _______________________________
State: _____________________________________
Parent’s Email: ___________________________________
Are you in default on any Federal Parent/Student Loans or do you owe a repayment on a federal grant?
Yes
No
Please indicate term and loan amount requested. Please be aware that a loan fee of 4% is assessed resulting
in a lesser amount crediting your student’s account. Award Year: ___________________________
Fall & Spring
$________________________
Original
Additional Amount
Fall Only
$________________________
Original
Additional Amount
Spring Only
$________________________
Original
Additional Amount
Summer Only
$________________________
Original
Additional Amount
For Office Use Only
Signatures: We certify that the information furnished on
this form is complete and correct, to the best of our knowledge. The parent borrower
signing below understands that by completing this form a credit check will be
GL
HRS
_DEP
_
performed by the Department of Education to determine eligibility for this loan.
REVISION
COA
$
_______________________________________
____________________________
Student Signature
Date
AID
-
Rem. Elig
_______________________________________
____________________________
Parent/Borrower Signature
Date
PLUS Amt. $
Please check here if you would like
ABAC to process a Direct Unsubsidized
Loan upon PLUS denial.
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