MEDICAL STUDENT LOAN AGREEMENT. THIS AGREEMENT is made this day of, 20, at

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1 MEDICAL STUDENT LOAN AGREEMENT THIS AGREEMENT is made this day of, 20, at Tucson, Arizona between, hereinafter referred to as Student, and the BOARD OF MEDICAL STUDENT LOANS, an agency of the State of Arizona, hereinafter referred to as the Board, pursuant to Arizona Revised Statutes (A.R.S.) through WHEREAS, Student has applied for a medical student loan, and WHEREAS, the Board has determined that the Student is qualified for such a loan, NOW, THEREFORE, IT IS AGREED as follows: 1. Subject to the availability of funds, appropriated by the Arizona Legislature for medical student loans, the Board will provide $ to Student to be paid within the academic year and divided into allotments for semester(s) or quarter(s). 2. Subject to Student's continued qualification as set out below and subject to the availability of funds appropriated by the Arizona Legislature, the Board stands ready to enter into subsequent loan agreements, not to exceed a total of five years, to provide the amount of tuition plus a living allowance of not more than $20,000 per year as adjusted as provided in A.R.S to Student, with consideration of the Student's need as determined by the Office of Student Financial Aid. 3. Student shall, during the continuation of the loan period, maintain Arizona residency and full-time enrollment at The University of Arizona College of Medicine, in good academic standing until completion of his or her course of medical studies. The Student, by signing this Agreement, certifies that he or she intends to enter and complete a residency program approved by the Accreditation Council for Graduate Medical Education and/or the American Osteopathic Association to become Board certified in Family Practice, Pediatrics, Obstetrics and Gynecology, Internal Medicine, combined Medicine and Pediatrics, or other specialty only upon written approval by the Board, and practice in a site in the State of Arizona approved by the Board. 4. Within three years following completion of his or her undergraduate medical education, unless extended to four years by the Board, Student shall obtain a license to practice medicine in Arizona and begin such practice in a site approved by the Board. A recipient who is ordered into military service, or for other cause beyond his or her control deemed sufficient by the Board, is unable to commence the required service within three years of such graduation, shall begin service within one year after completing military service or the termination of such other cause.

2 a. The services to be performed are service to the State of Arizona by practicing General Practice, Family Practice, general Pediatrics, combined Medicine and Pediatrics, Obstetrics and Gynecology, or general Internal Medicine in a service location approved by the Board. Service by practicing another specialty of recognized need in Arizona shall be allowed only with written approval by the Board. The qualifying services shall include direct patient care or services, including related administrative duties, diagnosis and treatment, and training provided to interns, residents, nurse practitioners, physician assistants, students and trainees, while providing direct patient care and services to persons in the community and its surrounding area. The services shall be provided on a full time basis for at least two years or one year of service for each academic year of loan support whichever is longer. b. Student shall notify the Board at least one year in advance of the date he or she will be available to begin the required service. Service must be approved by the Board to fulfill the provisions of this contract. Student will provide written documentation to be considered by the Board in the review process to determine if the service meets the qualifying criteria. c. The Board may approve service in any of the following locations, as defined in A.R.S : (1) A rural AND medically underserved area of Arizona. (2) A medically underserved area of Arizona. (3) A medically underserved population of Arizona. (4) Any Indian Reservation that is located in Arizona. 5. If Student fulfills the provisions of paragraph 4, the loans made to Student hereunder and all interest thereon shall be deemed fully paid. If the requirements of paragraph 4 are not fulfilled, Student shall repay the loan, together with interest at the rate of 7% per annum from the date(s) funds were made available by the Board until payment is made by or on behalf of Student, as follows: a. If Student completes his or her undergraduate medical education but decides not to complete service in a site approved by the Board, all funds paid to Student under this Agreement, including tuition, together with interest thereon plus liquidated damages suffered by the State of Arizona arising from Student's failure to complete service, as specified below, shall be repaid to the Board within one year following such a decision or the date such service was to have begun, whichever is later. The Board may for good reason provide for extensions on the period of repayment. Liquidated damages will be in an amount equivalent to the full amount borrowed, including tuition, less the amount credited for time actually served in a site approved by the Board, to be calculated on a prorated monthly basis. The Board may waive the payment of principal, interest, and liquidated damages if it determines that death or permanent physical disability accounts for the recipient's failure to fulfill the contract. b. On receipt of supporting documentation, the Board for good cause shown may defer the loan recipient's service or payment obligation or may enter into repayment arrangements with the loan recipient or allow service that is equivalent to full-time service if the Board determines that this action is justified after a review of the individual's circumstances.

3 c. If Student withdraws or is dismissed from medical school, all funds paid to Student under this Agreement, together with interest thereon, shall be repaid, with no penalty, within one year of withdrawal. The Board may for good reason provide for extensions on the period of repayment. 6. Student agrees to notify the Board in writing within thirty (30) days if any of the following occurs: any change in name, address, telephone number, or parents' address; Student withdraws, transfers, or graduates from the approved College of Medicine; any change in location of internship or residency program, service location, or change in any condition upon which the Board has granted a deferment of repayment or service. Student will give written notice within thirty (30) days of the change to the Board of Medical Student Loans c/o The University of Arizona College of Medicine Financial Aid Office, 1501 N. Campbell, P.O. Box , Tucson, AZ or other newer address provided to the borrower in writing from the Board of Medical Student Loans. If Student does not provide the notices as required by this paragraph, all amounts paid to Student may be forfeited, at the discretion of the Board, and repaid within one year or as directed by the Board. 7. The Attorney General is authorized to commence whatever actions are necessary to enforce the Agreement and achieve repayment of loans provided by the Board. 8. The terms and conditions of this Agreement shall be interpreted in accordance with the laws of the State of Arizona including particularly A.R.S through Audit of records: pursuant to A.R.S and , the Board shall retain and shall contractually require each subcontractor to retain all data, books and other records ( records ) relating to this Agreement for a period of five years after completion of the Agreement. All records shall be subject to inspection and audit by the State at reasonable times. Upon request the Board shall produce the original of any or all such records. 10. Cancellation for conflict of interest: pursuant to A.R.S , the State, its political subdivisions or any department or agency of either may, within three years after its execution, cancel any agreement, without penalty or further obligation, made by the State, its political subdivisions, or any of the departments or agencies of either if any person significantly involved in initiating, negotiating, securing, drafting or creating the Agreement on behalf of the State, its political subdivisions or any of the departments or agencies of either is, at any time while the Agreement or any extension of the Agreement is in effect, an employee or agent of any other party to the Agreement in any capacity or a consultant to any other party of the Agreement with respect to the subject matter of the Agreement. A cancellation made pursuant to this provision shall be effective when the Board receives written notice of the cancellation unless the notice specifies a later time. 11. Non-discrimination: the Board shall comply with Executive Order 99-4, which mandates that all persons, regardless of race, color, religion, sex, age, national origin or political affiliation, shall have equal access to employment opportunities, and all other applicable State and Federal employment laws, rules and regulations, including the Americans with

4 Disabilities Act. The Board shall take affirmative action to ensure that applicants for employment and employees are not discriminated against due to race, creed, color, religion, sex, national origin or disability. 12. Arbitration: the parties to this Agreement agree to resolve all disputes arising out of or relating to this Agreement through arbitration, after exhausting applicable administrative review, to the extent required by A.R.S except as may be required by other applicable statutes. BOARD OF MEDICAL STUDENT LOANS Board Member's Signature Student's Signature Typed Name Typed Name Address City State Zip code

5 Contract LOAN UA

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