FEDERAL PERKINS LOAN MASTER PROMISSORY NOTE

OMB No. 1845-0074 Form Approved Expiration Date 06/30/2009

Section A: Borrower Section
1. Name (last, first, middle initial) and 2. Social Security Number
Permanent Address (street, city, state, zip
3. Date of Birth (mm/dd/yyyy)
code)
4. Home Area Code/Telephone Number
5. Driver's License Number (List state abbreviation
first)

Section B: School Section

6. School Name & Address (street, city, state, 7. Annual Interest Rate
zip code)
5%

[Any bracketed clause or paragraph may be included at option of institution]

Terms and Conditions: (Note: Additional Terms and Conditions follow on subsequent pages)
APPLICABLE LAW - The terms of this Federal Perkins Loan Master Promissory Note (hereinafter called the Note) and any disbursements made under this Note shall be
interpreted in accordance with Part E of Title IV of the Higher Education Act of 1965, as amended (hereinafter called the Act), as well as Federal regulations issued under the
Act. All sums advanced under this Note are subject to the Act and Federal regulations issued under the Act.

REPAYMENT - I am obligated to repay the principal and the interest that accrues on my loan(s) to the above-named institution (hereinafter called the School) over a period
beginning 9 months (or sooner if I am a Less-Than-Half-Time Borrower) after the date I cease to be at least a half-time student at an institution of higher education or a
comparable School outside the United States approved by the United States Department of Education (hereinafter called the Department) and ending 10 years later, unless I
request in writing that my repayment period begin sooner. I understand that the School will report the amount of my installment payments, along with the amount of this loan
to at least one national credit bureau. Interest on this loan shall accrue from the beginning of the repayment period. My repayment period may be shorter than 10 years if I am
required by my School to make minimum monthly payments. My repayment period may be extended during periods of deferment, hardship, or forbearance and I may make
graduated installments in accordance with a schedule approved by the Department. I will make my installment payments in equal monthly, bimonthly, or quarterly
installments as determined by the School. The School may round my installment payment to the next highest multiple of $5. [I will make a minimum monthly repayment of
$40 (or $30 if I have outstanding Federal Perkins Loans made before October 1, 1992 that included the $30 minimum payment option or outstanding National Direct Student
Loans) in accordance with the Minimum Monthly Payment Section of the Terms and Conditions contained on the reverse side of this document.]

LATE CHARGES - The School may impose late charges if I do not make a scheduled payment when due or if I fail to submit to the School on or before the due date of the
payment, a properly documented request for any of the forbearance, deferment, or cancellation benefits as described below. No late charges may exceed 20 percent of my
monthly, bimonthly, or quarterly payment. The School may add the late charges to principal the day after the scheduled payment was due or include it with the next
scheduled payment after I have received notice of the charge, and such notice is sent before the next installment is due.

FORBEARANCE, DEFERMENT, OR CANCELLATION - I may apply for a forbearance, deferment, or cancellation on my loan. During an approved forbearance
period, payments of principal and interest, or principal only, may be postponed or reduced. Interest continues to accrue while my loan is in forbearance. During an approved
deferment period, I am not required to make scheduled installment payments on my loan. I am not liable for any interest that might otherwise accrue while my loan is in
deferment. If I meet the eligibility requirements for a cancellation of my loan, the institution may cancel up to 100 percent of the outstanding principal loan amount.
Information on eligibility and application requirements for forbearances, deferments, and cancellations is provided on pages 2 and 3 of this Note. I am responsible for
submitting the appropriate requests on time, and I may lose my benefits if I fail to file my request on time.

DEFAULT - The School may, at its option, declare my loan to be in default if (1) I fail to make a scheduled payment when due; (2) I fail to submit to the School, on or be-
fore the due date of a scheduled payment, documentation that I qualify for a forbearance, deferment, or cancellation; or (3) I fail to comply with the terms and conditions of
this Note or written repayment agreement. The School may assign a defaulted loan to the Department for collection. I will be ineligible for any further federal student finan-
cial assistance authorized under the Act until I make arrangements that are satisfactory to the School or the Department to repay my loan. The School or the Department shall
disclose to credit bureau organizations that I have defaulted and all other relevant loan information. I will lose my right to defer payments and my right to forbearance if I de-
fault on my loan. The School or the Department may accelerate my defaulted loan. Acceleration means that the School or the Department demands immediate payment of
the entire unpaid balance of the loan, including principal, interest, late charges, and collection costs. I will lose my right to receive cancellation benefits for service that is
performed after the date the School or the Department accelerated the loan.

CHANGE OF STATUS - I will inform the School of any change in my name, address, telephone number, Social Security Number, or driver's license number.

PROMISE TO PAY: I promise to pay the School, or a subsequent holder of the Note, all sums disbursed under the terms of this Note, plus interest and other fees which may
become due as provided in this Note. I understand that multiple loans may be made to me under this Note. I understand that by accepting any disbursements issued at
any time under this Note, I agree to repay the loans. I understand that each loan is separately enforceable based on a true and exact copy of this Note. I understand that I may
cancel or reduce the amount of any loan by not accepting or by returning all or a portion of any disbursement that is issued. If I do not make any payment on any loan under
this Note when it is due, I promise to pay all reasonable collection costs, including attorney fees, court costs, and other fees. I will not sign this Note before reading the entire
Note, even if I am told that I am not required to read it. I am entitled to an exact copy of this Note. This loan has been made to me without security or endorsement. My
signature certifies I have read, understand, and agree to the terms and conditions of this Note.

I UNDERSTAND THAT I MAY RECEIVE ONE OR MORE LOANS UNDER THIS MASTER PROMISSORY NOTE AND THAT I MUST REPAY SUCH
LOANS.

Borrower’s Signature Date

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Terms and Conditions (cont.) which the loan was made and the initial grace period has ended, only those
amounts in excess of the amount due for any repayment period shall be
considered a prepayment. If, in an academic year other than the academic
DISCLOSURE OF LOAN TERMS - I understand that under this Note, the year in which the loan was made, I repay more than the amount due for an
principal amount that I owe, and am required to repay, will be the sum of all installment, the excess funds will be used to repay principal unless I
disbursements issued unless I reduce or cancel any disbursements. The designate it as an advance payment of the next regular installment.
School will determine whether to make any loan under this Note after my
loan eligibility is determined. At or before the time of first disbursement for MINIMUM MONTHLY PAYMENT - If required by the School, I will
each loan, a disclosure statement will be provided to me identifying the make a minimum monthly payment in the amount of $40 (or $30 if I have
amount of the loan and any additional terms of the loan. I may decline a loan outstanding Federal Perkins Loans made before October 1, 1992 that
or request a lower amount by contacting the School. Any disclosure included the $30 minimum payment option or outstanding National Direct
statement I receive in connection with any loan under this Note is hereby Student Loans) or its bimonthly or quarterly equivalent. If the total monthly
incorporated into this Note. payment amount on this loan and any outstanding Federal Perkins Loans I
may have is less than the minimum monthly payment amount established by
LOAN REHABILITATION - If I default on my Federal Perkins Loan, the School, the School may still require a minimum monthly payment
and that loan has not been reduced to a judgment as a result of litigation amount. A minimum monthly payment amount will combine my obligation
against me, I may rehabilitate my defaulted loan by requesting the on this and all my outstanding Federal Perkins Loans, unless I have received
rehabilitation and by making a voluntary, on-time, monthly payment, as loans with different grace periods and deferments. At my request and if I
determined by the School, each month for twelve consecutive months. If I am eligible, the school may combine this minimum monthly payment
successfully rehabilitate my defaulted Federal Perkins Loan, I will again be amount with all my outstanding Federal Perkins Loans including those
subject to the terms and conditions and qualify for any remaining benefits made at other schools. Under these circumstances the portions of the
and privileges of this Note and the default will be removed from my credit minimum monthly payment that will be applied to this loan will be the
history. I understand that I may rehabilitate a defaulted Federal difference between the minimum monthly payment amount and the total
Perkins Loan only once. After my loan is rehabilitated, collection costs on amounts owed on a monthly basis on my other Federal Perkins Loans. If
the loan may not exceed 24 percent of the unpaid principal and accrued each school holding my outstanding Federal Perkins Loans exercises the
interest as of the date following the application of the twelfth consecutive minimum monthly payment amount option, the minimum monthly payment
payment. If I default on my rehabilitated loan, the cap on collection costs is amount will be divided among the Schools in proportion to the loan amount
removed. advanced by each school if I request this treatment from each School.

ASSIGNMENT - A loan made under this Note may be assigned by the FORBEARANCE - Upon making a properly documented written request
School only to the United States, as represented by the United States to the School, I am entitled to forbearance of principal and interest or
Department of Education. Upon assignment, the provisions of this Note principal only, renewable at intervals of up to 12 months for periods that
that relate to the School will, where appropriate, relate to the Department. collectively do not exceed three years, under the following conditions: If
my monthly Title IV loan debt burden equals or exceeds 20 percent of my
HARDSHIP REPAYMENT OPTIONS - Upon my written request, the total monthly gross income; if the Department authorizes a period of
School may extend my repayment period (1) for up to an additional 10 years forbearance due to a national military mobilization or other national
if I qualify as a low-income individual during the repayment period; or (2) emergency; or if the School determines that I qualify due to poor health or
for the period necessary beyond my 10 year repayment period if, in the for other reasons, including service in AmeriCorps. Interest accrues during
School’s opinion, prolonged illness or unemployment prevent me from any period of forbearance.
making the scheduled repayments. Interest will continue to accrue during
any extension of a repayment period. DEFERMENTS - To apply for a deferment, I must request the deferment
from the school. My request does not have to be in writing, but the School
If I am required by the School to make a minimum monthly payment on my may require that I submit supporting documentation to prove my eligibility
loan, the School may also permit me to pay less than the minimum monthly for a deferment. I may defer making scheduled installment payments and
payment amount for a period of not more than one year at a time if I will not be liable for any interest that might otherwise accrue (1) during any
experience a period of prolonged illness or unemployment. However, such period that I am enrolled and attending as a regular student in at least a half-
action may not extend the repayment period beyond 10 years. time course of study at an eligible School (If the School obtains student
enrollment information showing that I qualify for this deferment, the School
GRACE PERIODS - Unless I am a Less-Than-Half-Time Borrower, I will may grant the deferment without my request providing the School notifies
receive an initial nine-month grace period before the first payment of my me and gives me the option to cancel the deferment); (2) during any period
Federal Perkins Loan must be made. After the close of an authorized that I am enrolled and attending as a regular student in a graduate fellowship
deferment period, I will receive a post-deferment grace period of 6 months program approved by the Department; engaged in graduate or post-graduate
before my payments resume. Interest does not accrue during the initial fellowship-supported study outside the US; enrolled and attending a
grace period or during the post-deferment grace period. The nine-month rehabilitation training program for disabled individuals approved by the
initial grace period for Federal Perkins Loans does not include any period Department; or engaged in public service that qualifies me to have part or
up to three years during which I am called or ordered to active duty for all of my loan canceled; (3) for a period not to exceed three years during
more than 30 days from a reserve component of the Armed Forces of the which I am seeking but unable to find full-time employment; (4) for a
United States, including the period necessary for me to resume enrollment at period not to exceed three years, for up to one year at a time, during which I
the next available enrollment period. I must notify the school that made my am experiencing an economic hardship as determined by the School. I may
loan of the beginning and ending dates of my service, and the date I resume qualify for an economic hardship deferment for my Federal Perkins Loan if
enrollment. If I am in my initial grace period when called or ordered to I provide my school with documentation showing that I have been granted
active duty, I am entitled to a new nine-month initial grace period upon such a deferment under the William D. Ford Federal Direct Loan or Federal
completion of the excluded period. Family Education Loan program for the period of time for which I am
requesting an economic hardship deferment for my Federal Perkins Loan. If
If I am a Less-Than-Half-Time Borrower with outstanding Federal Perkins I am serving as a volunteer in the Peace Corps, I am eligible for an
Loans, my repayment period begins when the next scheduled installment of economic hardship deferment for my full term of service. An economic
my outstanding loan is due. If I am a Less-Than-Half-Time Borrower with hardship deferment based on service as a Peace Corps volunteer may not
no other outstanding Federal Perkins Loans, my repayment begins the exceed the lesser of three years or my remaining period of economic
earlier of: 9 months from the date my loan was made, or 9 months from the hardship eligibility; and (5) effective July 1, 2001, for a period not to exceed
date I became a less-than-half-time student, even if I received the loan after three years during which I am serving on active duty during a war or other
I became a less-than-half-time student. military operation or national emergency, or performing qualifying
National Guard duty during a war or other military operation or national
PREPAYMENT - I may prepay all or any part of my unpaid loan balance, emergency.
plus any accrued interest, at any time without penalty. Amounts I repay in
the academic year in which the loan was made and before the initial grace I may continue to defer making scheduled installment payments and will not
period has ended will be used to reduce the amount of the loan and will not be liable for any interest that might otherwise accrue for a six-month
be considered a prepayment. If I repay amounts during the academic year in

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Terms and Conditions (cont.) Cancellation Rate - For each completed year of service under the Military
Cancellation provision, this loan will be canceled at the rate of 12½ percent
of the original principal loan amount.
period immediately following the expiration of any deferment period
described in this section.
H. Volunteer Service Cancellation - Upon making a properly documented
written request to the School, I am entitled to have up to 70 percent of the
I am not eligible for a deferment while serving in a medical internship or
original principal loan amount of this loan canceled for qualifying service
residency program.
performed after the enrollment period covered by the loan as: • a volunteer
CANCELLATIONS - Upon making a properly documented written under the Peace Corps Act; • a volunteer under the Domestic Volunteer
request to the School, I am entitled to have up to 100 percent of the original Service Act of 1973 (ACTION programs).
principal loan amount of this loan canceled if I perform qualifying service in
the areas listed in paragraphs A, B, C, D, and E below. Qualifying service Cancellation Rate - For each completed year of service under the Volunteer
must be performed after the enrollment period covered by the loan. Service Cancellation provision, a portion of this loan will be canceled at the
following rates:
A. Teaching • a full-time teacher in a public or other nonprofit elementary • 15 percent of the original principal loan amount for each of the first and
or secondary school, designated by the Department in accordance with the second 12-month periods of service; and • 20 percent of the original
provisions of section 465(a)(2) of the Act as a school with a high principal loan amount for each of the third and fourth 12-month periods of
concentration of students from low-income families. An official Directory service.
of designated low-income schools is published annually by the Department.
• a full-time special education teacher in a public or nonprofit elementary or DISCHARGES - My obligation to repay this loan may be partially or
secondary school system; or • a full-time teacher, in a public or other totally discharged for the reasons specified in paragraphs A, B, C, and D
nonprofit elementary or secondary school system, who teaches below.
mathematics, science, foreign languages, bilingual education, or any other
field of expertise that is determined by the State Department of Education to A. Death - In the event of my death, the School will discharge the total
have a shortage of qualified teachers in that State. amount owed on this loan.

B. Total and Permanent Disability - If I become totally and permanently

B. Early Intervention Services • a full-time qualified professional provider
disabled after I receive this loan, the School will discharge the total amount
of early intervention services in a public or other nonprofit program under
owed on this loan. If my disability discharge claim is approved by the
public supervision by a lead agency as authorized by section 632(5) of the
School, this loan will be assigned to the United States Department of
Individuals with Disabilities Education Act. Early intervention services are
Education, which will discharge the total amount owed on this loan if it
provided to infants and toddlers with disabilities.
determines that I am eligible for a total and permanent disability discharge.
C. Law Enforcement or Corrections Officer • a full-time law C. School Closure - Under certain conditions, my total liability will be
enforcement officer for an eligible local, State, or Federal law enforcement discharged, including refunding any amounts I have already paid on the
agency; or • a full-time corrections officer for an eligible local, State, or loan, if I was unable to complete the program in which I was enrolled
Federal corrections agency. because my School closed.

D. Nurse or Medical Technician • a full-time nurse providing health care D. Bankruptcy - Under certain conditions, my loan may be discharged in
services; or • a full-time medical technician providing health care services. bankruptcy. In order to discharge a loan in bankruptcy, I must prove undue
hardship in an adversary proceeding before the bankruptcy court.
E. Child or Family Service Agency • a full-time employee of an eligible
public or private non-profit child or family service agency who is directly
providing or supervising the provision of services to high-risk children who Disclosure of Information
are from low-income communities and the families of such children.
STUDENT LOAN OMBUDSMAN - If I dispute the terms of my
Cancellation Rates - For each completed year of service under paragraphs Federal Perkins Loan in writing to my School, and my School and I are
A, B, C, D, and E a portion of this loan will be canceled at the following unable to resolve the dispute, I may seek the assistance of the Department
rates: of Education’s Student Loan Ombudsman. The Student Loan
• 15 percent of the original principal loan amount for each of the first and Ombudsman will review and attempt to informally resolve the dispute.
second years; • 20 percent of the original principal loan amount for each of
the third year and fourth years; and • 30 percent of the original principal
loan amount for the fifth year.
Notice About Subsequent Loans Made Under This
Master Promissory Note
F. Head Start Cancellation - Upon making a properly documented written
request to the school, I am entitled to have up to 100 percent of the original
This Note authorizes the School to disburse multiple loans during
principal loan amount canceled for qualifying service performed after the
the multi-year term of this Note upon my request and upon the
enrollment period covered by the loan as: • a full-time staff member in the School's determination of my loan eligibility.
educational component of a Head Start program which is operated for a Subsequent loans may be made under this Note for the same or
period comparable to a full School year and which pays a salary comparable subsequent periods of enrollment at this School. The School,
to an employee of a local educational agency. however, may, at its discretion, close this Note at any time and
require me to sign a new Note for additional disbursements. I
Cancellation Rate - For each completed year of service under the Head understand that if my School chooses to make subsequent loans
Start Cancellation provision, this loan will be canceled at the rate of 15 under this Note, no such loans will be made after the earliest of the
percent of the original principal loan amount. following dates: (i) the date the School receives my written notice
that no further loans may be disbursed under this Note; (ii) twelve
G. Military Cancellation - Upon making a properly documented written months after the date of my signature on this Note if no
request to the School, I am entitled to have up to 50 percent of the principal disbursement is made during such twelve-month period; or (iii) ten
amount of this loan canceled for qualifying service performed after the years after the date of my signature on this Note, or the date the
enrollment period covered by the loan as: • a member of the Armed Forces School receives this Note.
of the United States in an area of hostilities that qualifies for special pay Any amendment to the Act governs the terms of any loans
under section 310 of Title 37 of the United States Code. disbursed on or after the effective date of such amendment, and such
amended terms are hereby incorporated into this Note.

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 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 it displays a currently valid OMB
control number. The valid OMB control number for this information collection is 1845-0074. The time required to complete this information is estimated to
average 0.5 hours (30 minutes) per response, including the time to review instructions, search existing data resources, gather and maintain the data needed, and
complete and review the information collection. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving
this form, please write to:
U.S. Department of Education
Washington, DC 20202-4651

If you have any comments or concerns regarding the status of your individual submission of this form, write directly to the lender.

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