Parent Federal Direct PLUS Loan Pre-Application Award Year Requested:



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Parent Federal Direct PLUS Loan Pre-Application Award Year Requested: If you wish to apply for a Federal Direct Parent PLUS Loan during the academic year, you must complete this form. Please type or print clearly in blue or black ink and complete all items. Detailed instructions are on page 3 of this form. Parent Borrower s Information For purposes of the Federal Direct Parent PLUS Loan program, parent refers to the dependent student s natural mother or father, custodial stepparent, or adoptive parent. Check One: Mother Father Stepmother Stepfather Social Security Number: Last Name: First Name: MI: Date of Birth: Parent Address Information: Street: City: State: Zip Code: Phone Number: Email Address: Driver s License Information: State: Driver s License Number: Student Information: FVSU Identification Number: Social Security Number: Last Name: First Name: MI: Date of Birth:

Page 2 Borrower to Complete 1. Has or will the student file a FAFSA? Yes No 2. Total Loan Amount Requested (check one): I am applying for $ I am applying for maximum loan eligibility. 3. Loan requested for (check all that apply): Fall Term Spring Term Summer Term 4. U.S. Citizenship Status (check one): US Citizen or National (1) Permanent Resident or Eligible Non-citizen (2) Alien Registration Number Neither (3) 5. Are you currently in default on a federal education loan or owe a refund on a federal student grant? Yes No 6. *If the PLUS credit check is declined by the US Department of Education, your student may be eligible for additional unsubsidized loan funds. * Student must contact a financial aid counselor to request additional funds. Parent Borrower should complete the PLUS Loan master promissory note and application on-line at www.studentloans.gov.. A Federal PIN number is required to complete this process electronically. Obtain a Federal PIN at http://www.pin.ed.gov. I certify that the information provided on this form is complete and correct to the best of my knowledge. I acknowledge that I am applying for a loan that must be repaid. Parent Borrower s Signature: Date: Page 3

Fort Valley State University Federal Direct Parent PLUS Loan Pre-Application Instructions The Federal Direct PLUS Loan allows parents to borrow federal funds on behalf of a dependent child who is an undergraduate student. The U.S. Department of Education will obtain a credit report on the parent borrower listed on this pre-application. This credit check will be performed prior to the approval of a PLUS loan. A parent borrower who is deemed to have an adverse credit history may be eligible to obtain a PLUS loan with an endorser, or the student may be eligible to borrow additional unsubsidized loan funds. Parent Borrower s Information Information provided in this section pertains to the borrower (parent). Parent's Social Security Number: Enter your nine-digit social security number. Disclosure of your social security number is required to process and service a Federal Direct PLUS Loan. Parent s Name: Enter your legal name, first name and middle initial followed by your last name. Date of Birth: Enter the month, day and year of your birth. For example, if your date of birth is May 3, 1953, enter 05/03/1953. Permanent Address: Enter your permanent street address (no P.O. Boxes), including apartment number, city, state, and zip code. Permanent Phone Number: Enter the area code and phone number for the phone at your permanent address. Email Address: Enter a current email address so that we may correspond with you if needed. Driver s License: Enter the two-letter abbreviation of the state that issued your current driver s license, followed by the driver s license number. If you do not have a current driver s license, enter N/A. Student Information Information provided in this section pertains to the student. FVSU ID Number: Enter the student s Fort Valley State University identification number. This number was assigned to the student and is located on the student ID card. If not available, leave blank. Student s Social Security Number: Enter the student s nine-digit social security number. Disclosure of the social security number is required to process the Federal Direct PLUS Loan. Student s Name: Enter the student s legal name, first name and middle initial followed by the last name. Date of Birth: Enter the month, day and year of student s birth. For example, if the date of birth is June 1, 1989, enter 06/01/1989. Local Phone Number: Enter the area code and local phone number so that we may reach you if needed. Page 4

Section to be completed by Parent Borrower Filing a FAFSA: Students are required to complete a Free Application for Federal Student Aid (FAFSA) to be considered for other forms of financial aid. If you are only interested in a PLUS Loan, completion of a FAFSA is not required. Loan Amount Requested: Enter the amount of money that you intend to borrow. In requesting a specific amount of funds, you should select the smallest amount of money that will satisfy the student s cost of attending school. You should remember that these funds are a loan from the U.S. Department of Education and must be repaid. The maximum amount that is available to a Direct PLUS Loan borrower on behalf of an eligible student is limited to the cost of the student s education. The Direct PLUS Loan, together with all other financial aid, may not total more than the student s cost of attendance. There is no limit on the maximum aggregate amount that is available to Direct PLUS Loan borrowers. FVSU is responsible for making the final determination of a student s cost of attendance. Estimated costs for the award year are provided on the FVSU web site at www.fvsu.edu.. Loan Period: Enter the enrollment period for which this loan is requested. Summer includes any sessions from May through August. Student s Planned Enrollment: Cost of attendance is based on credit hours taken during each term. If your student expects to be less than full time status, please indicate the total credit hours expected for each term. U.S. Citizenship: Place a check in the box that corresponds with your citizenship status. If appropriate, enter the Alien Registration Number. The Direct PLUS Loan Program is intended to provide financial aid to parents who are either U.S. citizens, U.S. nationals, permanent residents, or certain Pacific Islanders who intend to become citizens or permanent residents of the United States. The term U.S. citizen or national includes citizens of the 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, and the Northern Mariana Islands. National includes not only all U.S. citizens, but also citizens of American Samoa and Swain s Island. A permanent resident of the United States is someone who can provide documentation of this status from the U.S. Citizenship and Immigration Services (USCIS). An eligible noncitizen is an individual who can provide documentation from the USCIS that he/she is in the United States for a purpose that is not temporary, with the intention of becoming a citizen or permanent resident. This category includes refugees, persons granted asylum, Cuban-Haitian entrants, temporary residents under the Immigration Reform and Control Act of 1986 and others. Default/Owe Refund on Federal Aid: If you are not in default on a federal education loan and do not owe a refund on a federal student grant. A borrower who has made satisfactory arrangements with the holder of their loan or the U.S. Department of Education to regain eligibility for all Title IV student financial assistance upon the borrower s payment of six consecutive monthly payments of a defaulted loan can check No. Page 5

Parent s Signature: Sign and date the PLUS Pre-Application. Your signature acknowledges that the U.S. Department of Education will complete a credit check for this borrower to determine PLUS Loan eligibility. Return this completed form to: The Fort Valley State University 1005 State University Drive Fort Valley, Georgia 30310 Or Fax (478) 825-6976 Page 6

Federal Direct Parent PLUS Borrower Refund Request Form Dear Federal Direct Parent PLUS Borrower: Once your loan application/promissory note has been returned to the Office of Financial Aid, the information will be transmitted to the Federal Direct Loan Servicer. The Federal Direct Loan Servicer will review the credit check information which was completed prior to the printing of the enclosed application/promissory note and advise you if there are conditions which would prohibit the approval of your loan. After your loan has been processed and approved, funds will be disbursed to the student s account at the beginning of each semester included in the loan period. Federal Direct PLUS loan funds may only be applied toward University tuition, academic fees, oncampus room/meal plan and University health insurance. All other miscellaneous charges such as FVSU bookstore purchases, fines, recreation center fees and health center services will be the student s responsibility to pay. Your student may still have a balance owed despite receiving a financial aid refund check with the PLUS loan. It will be your student s responsibility to satisfy payment obligation for his/her miscellaneous charges owed to FVSU by the Student Financial Services billing due date. If you wish to have any credit balance created by the PLUS funds refunded to your student, you must complete the items below and return this form to the Office of Financial Aid. Once reviewed, this agreement will remain in effect until the Office of Financial Aid is notified in writing. If this form is not returned, FVSU will forward any credit balance created by the PLUS funds to you to apply to the student s miscellaneous expenses. I understand that Fort Valley State University will disburse my Federal Direct PLUS funds to my student s account in equal disbursements for each semester included in the loan period. By signing below, I authorize FVSU to directly refund any credit balance created by the Federal Direct PLUS funds to my student in his/her name. Print Student s Name: Student s FVSU ID: Student s Social Security Number: Print PLUS Borrower s Name: Print PLUS Borrower s Social Security Number: Award Year: PLUS Borrower s Signature: Date: Return this form and the application to: Fort Valley State University Office of Financial Aid 1005 State University Drive Fort Valley, Georgia 30310 or fax to (478) 825-6976