Federal Direct Consolidation Loan Application and Promissory Note with Additional Loan Listing Sheet

			Federal Direct Consolidation Loan Additional Loan Listing Sheet WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any accompanying documentation is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097. [C-30-DAY DRAFT 11/22/2010]				OMB No. 1845-0053 Form Approved Exp. Date xx/xx/xxxx
Borrower Name
Borrower Social Security Number
Use this form only if you need additional space to list loans in Sections C1 or C2 of your Federal Direct Consolidation Loan Application and Promissory Note (Note). Refer to the instructions for Items 13-21 when completing this form. Be sure to attach this form to pages 1, 2, and 3 of your Note when you submit it.
Section C1: Education Loan Indebtedness – Loans You Want to Consolidate (continued)
Read the Federal Direct Consolidation Loan Instructions for Application and Promissory Note before completing this section. List each federal education loan that you want to consolidate, including any William D. Ford Federal Direct Loan (Direct Loan) Program loans that you want to include in your Direct Consolidation Loan. List each loan separately. Please print. IN THIS SECTION, LIST ONLY LOANS THAT YOU WANT TO CONSOLIDATE.
13. Loan Code (See Instructions)	14. Loan Holder/Servicer Name, Address, and Area Code/Telephone Number (See Instructions)				15. Loan Account Number		16. Estimated Payoff Amount
Section C2: Education Loan Indebtedness – Loans You Do Not Want to Consolidate (continued)
Read the instructions before completing this section. List all education loans that you are not consolidating, but want to have considered when calculating your maximum repayment period. Include any Direct Loan Program loans that you do not want to consolidate. List each loan separately. Please print. IN THIS SECTION, LIST ONLY LOANS THAT YOU DO NOT WANT TO CONSOLIDATE.
18. Loan Code (See Instructions)	19. Loan Holder/Servicer Name, Address, and Area Code/Telephone Number (See Instructions)				20. Loan Account Number		21. Current Balance