Loan Data Verification Form (Page 2 of 2) in pdf

Instructions for the Loan Data Verification form

General

$ Complete Section A to the best of your ability; sign and date the form; and send it to: Mississippi Office of Student

Financial Aid, 3825 Ridgewood Road, Jackson, MS 39211.

$ If you have questions, contact the Mississippi Office of Student Financial Aid at 601-432-6997 or 1-800-327-2980

(toll free in Mississippi).

Item (Items not listed are considered to be self-explanatory.)

Social Security Number

The Social Security Number (SSN) is required to identify applicants who are selected for the MTLR program.

Your SSN is used for identification purposes only.

3a.

Name and Address of Lending Institution/Loan Holder

Enter the name and address of the institution which currently holds your loan. This would be the name and

address of the company to which you send payments.

3b.

Loan Account Number

The loan account number is required to identify and issue repayments for eligible loans of applicants selected

for MTLR. The number provided should be unique and distinguish this loan account from other loan accounts

held by the same lender. Include any prefix or suffix used by your lender(s).

4-5. Current Balances

List loan balances and interest rate, if available.

Current Loan Status

Indicate whether your loans are currently in deferment status or whether you are currently making payments.

Payments Up-to-date

Indicate >No= if your loan is delinquent, in default, or is not current in its payment schedule. Loans in these

categories are not eligible for repayment. Indicate >Yes= only if you have made payments to your loan as

required under the terms of your agreement/note and no penalties are outstanding.

12.

Certification

Your signature attests to the accuracy of information provided as well as authorizes the Mississippi Office of

Student Financial Aid or any of its agencies to request, and your lending institution/ servicing agent to release,

information concerning your loan.

Loan Data Verification Form Page 2