Tpd Disharge Assignment Form - U.s. Department Of Education - 2010 Page 4

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Title IV Guaranteed Educational Loans TPD Discharge Assignment Form – Continued
BORROWER NAME:
SSN:
SECTION C - HISTORICAL LOAN INFORMATION (complete separately for each loan)
43. Indicator of Separate Loan
44. Loan Type
45. Claiming Lender ID Number
46. Original Lender ID Number
47. PLUS/GPLS Student Name (Last, First, Middle)
48. PLUS/GPLS Student SSN
49. PLUS/GPLS Student Birth Date
50. School ID Number
(MM/DD/CCYY)
51. Date of Loan Guaranty
52. Date of First Disbursement
53. Date of Last Disbursement
(MM/DD/CCYY)
(MM/DD/CCYY)
(MM/DD/CCYY)
54. Date of Withdrawal (MM/DD/CCYY)
55. Date Entered Repayment (MM/DD/CCYY)
56. Date of Default (MM/DD/CCYY)
57. Date Claim Paid to Lender
58. Date of Last Payment to GA
59. Date of First Treasury Offset
(MM/DD/CCYY)
(MM/DD/CCYY)
Certification (MM/DD/CCYY)
60. Date of Judgment (MM/DD/CCYY)
61. Judgment Expiration Date
62. Interest Deduction Months
(MM/DD/CCYY)
63. Amount of Disbursement
64. Date Opened for Credit Bureau Reporting
65. Amount of Loan Guaranty
(MM/DD/CCYY)
66. OPE School ID
67. Current Interest Rate Type
68. Current Interest Rate
69. Variable Interest Add-On Rate
70. Interest Rate Cap
71. Current Balance Date (MM/DD/CCYY)
72. Collection Fee Cap
73. Amount Collected by GA
74. Principal Amount Paid to Lender by GA
75. Interest Paid to Lender by GA
76. Interest Capitalized by GA and/or Lender
77. Current Principal Balance
78. Current Interest Balance
79. Current Penalties
80. Current Collection Fees
81. Current Treasury Offset Fees
82. Current Administrative Fees
83. Current Miscellaneous Fees
84. Outstanding Capitalized Interest
85. Outstanding Loan Origination Fee
86. Ineligible Borrower Indicator
87. Rehabilitation Indicator (Y or N)
88. Electronically Signed Note Indicator (Y or N)
89. Entity in Possession of the Original Electronic Note

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