Fillable Perkins Loan Master Promissory Note Template (Page 4 of 4) in pdf

Terms and Conditions (cont.)

D. Bankruptcy - Under certain conditions, my loan may be discharged in

Notice About Subsequent Loans Made Under This

bankruptcy. In order to discharge a loan in bankruptcy, I must prove undue

Master Promissory Note

hardship in an adversary proceeding before the bankruptcy court.

This Note authorizes the School to disburse multiple loans

during the multi-year term of this Note upon my request and upon

Disclosure of Information

the School's determination of my loan eligibility.

Subsequent loans may be made under this Note for the same or

STUDENT LOAN OMBUDSMAN - If I dispute the terms of my

subsequent periods of enrollment at this School. The School,

Federal Perkins Loan in writing to my School, and my School and I are

however, may, at its discretion, close this Note at any time and

unable to resolve the dispute, I may seek the assistance of the Department

require me to sign a new Note for additional disbursements. I

of Education’s Student Loan Ombudsman. The Student Loan

understand that if my School chooses to make subsequent loans

Ombudsman will review and attempt to informally resolve the dispute.

under this Note, no such loans will be made after the earliest of the

following dates: (i) the date the School receives my written notice

that no further loans may be disbursed under this Note; (ii) twelve

months after the date of my signature on this Note if no

disbursement is made during such twelve-month period; or (iii) ten

years after the date of my signature on this Note, or the date the

School receives this Note.

Any amendment to the Act governs the terms of any loans

disbursed on or after the effective date of such amendment, and such

amended terms are hereby incorporated into this Note.

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 §461 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C.

1087aa et seq.) and the authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31

U.S.C. 7701(b). 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 forgiveness) under the Perkins Program, to permit the servicing of your loan(s), and,

if it becomes necessary, to locate you and to collect and report 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, on a case by case basis or under a computer matching program, to third parties as authorized under routine uses

in the appropriate systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local

agencies, to private parties such as relatives, present and former employers, business and personal associates, to consumer reporting agencies, to financial and

educational institutions, and to guaranty agencies 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 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,

disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history information,

disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to

guaranty agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions

efficiently to submit student enrollment status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in

repayment efforts, disclosures may be made to guaranty agencies, to financial and educational institutions, or to federal, state, or local agencies.

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

be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records. Before making any such disclosure,

we will require the contractor to maintain Privacy Act safeguards. 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 such collection displays a

currently valid OMB control number. The valid OMB control number for this information collection is 1845-0074. Public reporting burden for this collection

of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and

maintaining the data needed, and completing and reviewing the information collection. The obligation to respond to this collection is required to obtain or

retain benefit (Higher Education Act of 1965, as amended (20 U.S.C. 1087dd)). If you have any comments or concerns regarding the status of your

individual submission of this form, please contact your lender directly.

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