Federal Stafford Loan School Certification, 1845-0006

Federal Stafford Loan Master Promissory Note

FFEL Stafford MPN Loan Cert.Exp 07-31-2011.OMB DRAFT-C.02-10-2009

Federal Stafford Loan Master Promissory Note (MPN) and School Certification

OMB: 1845-0006

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Federal Family Education Loan Program (FFELP)

Federal Stafford Loan

School Certification

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any accompanying document is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.


G

OMB No. 1845-0006

Form approved

Exp. date 07/31/2011

uarantor, Program, or Lender Identification




CLEAN DRAFT 02-10-2009



(Reserved for school, lender, or guarantor mailing address as appropriate)



  1. School Code


  1. School Information (Name, address, and phone number)








Borrower Information (To be completed by a financial aid administrator or other school official authorized to certify financial aid forms. See the instructions for completing this form on the next page.)

3. Last Name First Name MI



4. Social Security Number

5. Permanent Address (See instructions.)



6. Area Code/Telephone Number

7. Date of Birth (mm-dd-yyyy)

City State Zip Code



8. E-mail Address

9. Lender Name/Lender Code, if known City State



10. Grade Level




11. Enrollment Status (Check one)

Full Time


At Least Half Time

12. Anticipated Graduation (Completion) Date (mm-dd-yyyy)

13. Loan Period (mm-dd-yyyy)


From: To:

14. Certified Loan Amounts


a. Subsidized $ .00 b. Unsubsidized $ .00

15. Recommended Disbursement Date(s) (mm-dd-yyyy)



1st 2nd 3rd 4th 5th 6th


This space reserved for additional disbursement dates, if needed.




School Certification

I certify:

  • That the borrower named on this Certification is accepted for enrollment in an eligible program on at least a half-time basis; is a U.S. citizen, permanent resident, or other eligible non-citizen; and is making satisfactory academic progress;

  • That the borrower is an eligible borrower in accordance with the Higher Education Act of 1965, as amended, and applicable U.S. Department of Education regulations (collectively referred to as the Act), that the borrower’s eligibility for a Federal Pell Grant has been determined, and that the borrower has been determined eligible for a loan(s) in the amount(s) certified;

  • That the disbursement schedule complies with the requirements of the Act;

  • Based on available records and appropriate inquiry, that:

(i) the borrower has met the requirements of the Selective Service Act;

(ii) the borrower is not incarcerated;

(iii) the borrower is not liable for an overpayment of any federal grant or loan under the Act;

(iv) the borrower is not in default on any Title IV education loan(s); or, if the borrower is in default, satisfactory repayment arrangements have been made with the holder(s) of any defaulted loan(s);

(v) the borrower has not been convicted of or pled nolo contendere (no contest) or guilty to a crime involving fraud in obtaining funds under Title IV of the Act; or, if the borrower has pled nolo contendere or guilty to such a crime, the borrower has repaid the funds to the Secretary of Education or to the loan holder in the case of a Title IV federal student loan;

(vi) the borrower does not have property subject to a judgment lien for a debt owed to the U.S.; and

(vii) the information provided in this Certification is true, complete, and accurate to the best of my knowledge and belief.

I agree to provide the borrower with (i) confirmation of any transfer of funds through electronic funds transfer (EFT) or master check to the borrower’s student account, and (ii) an opportunity to cancel or reduce any disbursement of a loan.


16. Signature of Authorized School Official _____________________________________________________________ 17. Today’s Date (mm-dd-yyyy)________________________________



Name/Title (Printed or Typed) _______________________________________________________________________________________________________________________________





Instructions for Completing a Federal Stafford Loan School Certification


Important Notice: If certification information is transmitted electronically, do not complete the School Certification form.


Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: June 24, 1982 = 06-24-1982.



Item 1: Enter the code for your school. This code is provided by the U.S. Department of Education for the Federal Family Education Loan Program.


Item 2: Enter your school name and address, and the telephone number, including area code, of a school official who can answer questions about this certification.


Item 3: Enter or correct the borrower’s last name, first name, and middle initial.


Item 4: Enter or correct the borrower’s Social Security Number. This loan cannot be processed without the borrower’s Social Security Number.


Item 5: Enter the borrower’s permanent address (number, street, apartment number) or rural route number and box number, then city, state, and zip code. If the borrower’s mailing address is a post office box or general delivery, list both the mailing address and the street address or rural route number and box number. If the borrower does not have a permanent street address or rural route number and box number, provide the physical location of the borrower’s residence. A temporary school address is not acceptable.


Item 6: Enter the borrower’s area code and telephone number. If the borrower does not have a telephone, enter N/A.


Item 7: Enter the date of the borrower’s birth. Be careful not to enter the current year.


Item 8: Enter the borrower’s e-mail address, if known.


Item 9: Enter the borrower’s lender selection (name, identification number, city, and state), if known.


Item 10: Enter the grade level of the borrower. Select the proper grade level indicator using the standard grade level codes provided:















Code Grade Level


  1. Freshman/First-Year (including proprietary school programs that are less than one year in duration)


  1. Sophomore/Second-Year


  1. Junior/Third-Year


  1. Senior/Fourth-Year


  1. Fifth-Year/Other Undergraduate (including sixth-year undergraduate and continuing education students)


  1. First-Year Graduate or Professional


  1. Second-Year Graduate or Professional


  1. Third-Year Graduate or Professional


  1. Beyond Third-Year Graduate or Professional


Item 11: Indicate whether the borrower is (or plans to be) enrolled at least half time or full time. A borrower who is enrolled (or planning to enroll) less than half time is not eligible for a Federal Stafford Loan.


Item 12: Enter the date the borrower is expected to complete the program at your school. If you are unsure of the actual completion date in the future, enter the last day of the month.


Item 13: Enter the dates covered by the cost of attendance. These dates must coincide with actual term starting and ending dates. At a school without academic terms, these dates must coincide with the borrower’s program of study if that is less than an academic year in length, or the academic year.


Item 14: Enter the lesser of the amount of the borrower’s eligibility for each loan type, or the loan amount requested by the borrower. An undergraduate borrower’s eligibility must be reduced if the borrower is attending a program with a length of less than a full academic year, or completing the remaining balance of a program in a period of less than an academic year. The borrower’s eligibility may also be reduced based on professional judgment. If this field is left blank, the loan(s) will be delayed.



Item 14a: Enter the lesser of the borrower’s eligibility for a subsidized Federal Stafford Loan or the subsidized Federal Stafford Loan amount requested by the borrower. If the borrower is not eligible for a subsidized Federal Stafford Loan, enter 0.


Item 14b: Enter the lesser of the borrower’s eligibility for an unsubsidized Federal Stafford Loan or the unsubsidized Federal Stafford Loan amount requested by the borrower. If the borrower is not eligible for an unsubsidized Federal Stafford Loan, enter 0.


Item 15: Enter the disbursement dates for this

loan(s) as determined in accordance with the Act.


Item 16: Your signature acknowledges that you have read and agree to the provisions in the School Certification. You must sign the Certification and print your name and title.


Item 17: Enter the date of certification.





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 1845-0006. The time required to complete this information is estimated to average 0.15 hours (9 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 20202-4537



File Typeapplication/msword
File TitleFederal Family Education Loan Program (FFELP)
AuthorEPBSMITH
Last Modified Bydoritha.ross
File Modified2009-02-12
File Created2009-02-12

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