Federal Perkins Student Loan Program - Slcc (Page 2 of 2) in pdf

Federal Perkins Student Loan Program - Slcc Page 2

CREDITOR INFORMATION:

****REQUIRED COPIES OF CREDITORS INVOICES****

MONTHLY PAYMENTS / TOTAL AMOUNT DUE

Rent

$_______________________________

Auto

$_______________________________

CREDITOR

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

_________________________________________________________

$_______________________________

TOTAL $_______________________________

Additional Comments:

_________________________________________________________________________________________________

I CERTIFY THAT THE INFORMATION I HAVE PROVIDED IS TRUE AND CORRECT. I HEREBY

AUTHORIZE VERIFICATION OF ALL INFORMATION PROVIDED TO SALT LAKE COMMUNITY

COLLEGE, STUDENT LOANS & RECEIVABLES DEPARTMENT.

BY SIGNING BELOW I AGREE TO THE ABOVE STATEMENT…

_______________________________________________________________

___________________

Signature

Date

Federal Perkins Student Loan Program - Slcc Page 2