School Lender GA and State Agency Enrollment Documents - Private Sector

Student Aid Internet Gateway (SAIG)
Enrollment Form
For State Scholarship and Grant Agencies

OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

State Scholarship and Grant Agency Form

Page 1

Enrollment to Participate in the U.S. Department of Education’s Student Aid Internet Gateway (SAIG)
The Student Aid Internet Gateway (SAIG) was established to allow a variety of entities that participate in the Title IV,
HEA programs to exchange data electronically with the U. S. Department of Education (ED, Department). In order to
participate in the SAIG, each entity must enroll for access. The enrollment process will enable you to establish your
Organization with services to receive, submit, view and update student financial aid data online and by batch using
EDconnect or TDClient software.
Each entity has an individual designated as the Primary Destination Point Administrator (Primary DPA). Each entity also
is provided with a Primary Destination Point (which is identified by a TG Number/Mailbox). The Primary DPA is the only
person within the organization who may enroll other staff as Non-Primary DPAs with Destination Points assigned for
specific SAIG services. Upon completing the enrollment process, the Primary DPA can add or remove users, edit
information about the entity, or change the entity’s enrollment in various SAIG services.
As required for eligibility to access Federal Student Aid Systems, the Primary DPA must validate the individuals enrolled
for SAIG Mailbox and online services for your organization on a schedule determined by ED. If validation is not
completed via the SAIG Enrollment Web site within the prescribed timeframe, all services assigned to the organization
and individuals could be permanently deactivated.

Notes About This Document
“We” and “us” refer to the U.S. Department of Education (ED, Department). “You” and “your” refer to the Primary DPA
of the state scholarship and grant agency applying to participate in ED’s Student Aid Internet Gateway, referred to as the
SAIG.
The first usage of a term in this document is italicized and can be found in the glossary at the end of this form. This
glossary will assist you in understanding many technical terms and acronyms commonly used in the Title IV, HEA student
financial aid programs.

About Enrollment
If you use this form to add and change information, check Box B in Step One, Question 1; fill in the information that has
changed for any questions in Steps One and Two; complete Steps Three, Four, and Five and send your application to the
address below.
Application for enrollment in the SAIG (and changes to enrollment) can also be completed online at
https://fsawebenroll.ed.gov.
You may photocopy this form, but you must always send us original signatures for Step Four and Step Five. We will not
accept photocopied or stamped signatures. Forms submitted after the OMB Expiration Date noted on this
application will not be accepted.
If you have any questions about completing your application, call CPS/SAIG Technical Support at 1-800-330-5947. To
reach a telecommunications device for the deaf (TDD/TTY), call 1- 800-511-5806. Technical support representatives are
available 7 a.m. – 7 p.m. CT, Monday through Friday, excluding federal holidays. If you prefer, you can e-mail inquiries
to [email protected]. A technical support specialist will respond to your e-mail within one business day.

Send your completed enrollment form and original, signed signature pages to:

CPS/SAIG Technical Support
2450 Oakdale Blvd.
Coralville, Iowa 52241
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

State Scholarship and Grant Agency Form

Page 2

Available Services For State Scholarship and Grant Agencies
By completing this application, you will be enrolling an individual as the Primary Destination Point Administrator
(Primary DPA) who will be responsible for the administration of services assigned to the State scholarship and grant
agency’s primary Destination Point (which is identified by a TG Number/Mailbox). Enrollment is designed to secure the
integrity of data that is exchanged between you and the Federal Student Aid systems accessed over the SAIG or online.
These systems include the Central Processing System (CPS) and the National Student Loan Data System (NSLDS).
State scholarship and grant agencies receive processed applicant data from the CPS. You may receive data for residents
(those who indicate your state as their state of legal residence) and/or non-residents (those who indicate an institution that
is within your state but do not indicate your state as their state of legal residence). You may also receive data for individual
students who do not meet either of these two conditions, as long as you maintain signed forms whereby the students
release their data to you.
The services that state scholarship and grant agencies can access over the SAIG are:


Automatic Electronic Institutional Student Information Record (ISIR) processing: With this option, ISIRs are
automatically transmitted to you when students submit applications and corrections. The ISIR contains information
submitted by the student, as well as, CPS processing results. If a student does not release data to your state, only
certain demographic and processing result fields are provided on the ISIR you receive.



The ISIR Datamart Request process: This service allows any agency to electronically request a processed record for
any student on the CPS database through FAA Access to CPS Online. If the student is not a resident of your state or
attending an institution in your state, the student must have submitted a substantially completed and signed loan or
state grant application that releases CPS data to you. You must maintain the signed application.



You may also request online access to NSLDS to view Title IV, HEA loan, grant, and enrollment history necessary to
perform state scholarship and grant agency functions.

How the Enrollment Process Works
When the Primary DPA enrolls a Non-Primary DPA, for a Destination Point, a “TG” number will be assigned that
identifies the new Non-Primary DPA’s Destination Point (Mailbox) in the SAIG. The TG number will be sent to the new
Non-Primary DPA upon successful processing of the enrollment form.
Only one Destination Point (TG Number/Mailbox) can be established to exchange data available from the CPS. The
Primary DPA will determine the EDconnect and TDClient users who are allowed access to that Destination Point (TG
Number/Mailbox). The Primary DPA must enforce the security requirements as outlined in the Federal Student Aid User
Statement (see Attachment B). The organization’s President/CEO, the equivalent, or designee must certify that the Primary
DPA has developed secure procedures in compliance with the security requirements for permitting other people to use his
or her Destination Point (TG Number/Mailbox) (see Step Five). The Primary DPA also must complete a Federal Student
Aid User Statement for each user that is assigned a User ID within the EDconnect and TDClient software, which is used to
connect to the SAIG.
An unlimited number of Destination Points may be established for your organization for view-only access to NSLDS
Online. Each user that enrolls for NSLDS Online access is the Non-Primary DPA for his or her own mailbox. That
mailbox is in turn associated with the Primary DPA of your organization. Only the Primary DPA can add or remove users
through the enrollment process.
To complete the SAIG enrollment application, you will need the following information:


Currently enrolled organizations will need their existing Primary Destination Point (TG Number/Mailbox) and the
name of the Primary DPA. An FSA User ID and password are required to access enrollment information. To obtain
an FSA User ID, go to https://fsawebenroll.ed.gov/PMEnroll/PMAccountServlet.jrun, provide identifying information,

OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

State Scholarship and Grant Agency Form

Page 3

and follow the remaining registration steps. Once you have completed the registration process, including establishing
your password, your FSA User ID will be e-mailed to you.


All entities will need the name, address, Social Security Number (SSN), date of birth, and mother’s maiden name for
each DPA.

Once we receive all necessary signatures, we will process your enrollment. If your enrollment was for a new TG number,
we will send your SAIG TG number to you. If your enrollment was for NSLDS Online and access is granted, the User ID
will be sent to you from NSLDS.
Note: If you want to cancel the enrollment of any DPAs, send a letter on organization letterhead identifying the TG
numbers that you want cancelled. The letter should be mailed to CPS/SAIG Technical Support, 2450 Oakdale Blvd.,
66666666666666666666
Coralville, IA 52241. You may also cancel online at https://fsawebenroll.ed.gov.

Instructions for Completing Enrollment
Step One – must be completed by all applicants
Step One collects information about your organization and the DPA you want to enroll or for whom you are changing or
adding information.
1.

This enrollment form can be used for multiple purposes. As the Primary DPA, you may use the enrollment form
to enroll new participants in the SAIG and you can also use the enrollment form to change or to add information
about an existing DPA or Destination Point (TG Number/Mailbox).
A. Check Box A for “initial application” if you are a first-time participant and your organization does not have a TG
number.
B. Check Box B to “add a new user” if your organization is enrolled in the SAIG and you want to add a Destination
Point (TG Number/Mailbox).
C. Check Box C to “change information for existing Destination Point/Mailbox” if your organization is enrolled in the
SAIG and you want to change or add any information about an existing Destination Point (TG Number/Mailbox).
Fill in the information that has changed for any questions in Steps One and Two; and complete Steps Three, Four,
and Five.
If you are uncertain of what to complete, call CPS/SAIG Technical Support at 1-800-330-5947. To reach a
telecommunications device for the deaf (TDD/TTY), call 1-800-511-5806.

2.

Provide the name of your organization, as you would like it to appear on all SAIG correspondence. (The limit is
40 characters, including letters and spaces.)

3.

Confirm your type of organization.

4.

As the Primary DPA, you must identify the DPA you want to enroll or for whom you are changing or adding
information. All information must be provided for the DPA you wish to enroll for the organization you identified
in Question 2. Note: Do not use a group e-mail address.

Step Two
In Step Two you will choose the services for which your institution requires enrollment.
5. A. Check the boxes for the type of ISIR services you wish to receive.
B. Check the boxes for the award years this DPA should receive the applicant data.
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

State Scholarship and Grant Agency Form

Page 4

C. Choose the preferred delivery option for ISIRs if ISIRs are selected in Question 5-A. You can choose whether to
receive ISIRs on a daily basis or by request. Daily receipt is the default ISIR delivery method. If you choose “by
request,” you must request ISIRs from the ISIR Datamart. The ISIRs are then sent to your Destination Point (TG
Number/Mailbox) through the SAIG. With either option, you can request a single ISIR or a specified group of
ISIRs at any time.
6.

If you would like NSLDS Online access to view Title IV, HEA loan, grant, and enrollment history, check the
‘Yes’ box, check the ‘NSLDS Online-View Only’ box, specify your state, and select all applicable job functions.

Step Three
Step Three collects the required Agency Participation Agreement to receive electronic ISIRs.

Step Four – must be completed by all applicants
Step Four collects the required agreements from the DPA identified in Step One.
Each DPA must read and sign the Responsibilities of the Primary and Non-Primary Destination Point Administrators
statement.
The original signature form must be attached to your completed enrollment form and submitted to CPS/SAIG
Technical Support, 2450 Oakdale Blvd., Coralville, Iowa 52241.
A copy of each signed and dated statement must be maintained by your organization. Once we receive all
necessary signatures from you, we will process your enrollment. If your enrollment was for a new TG Number,
we will e-mail your SAIG TG Number/Mailbox to you.

Step Five – must be completed by all applicants
Step Five collects the required authorization from your organization to process the enrollment information for the DPA
you have identified in Step One.
For each Destination Point (TG Number/Mailbox), the chief officer of the organization (President, CEO, equivalent
person, or designee) who is legally authorized to execute the Agreement for and on behalf of the Agency must sign the
Certification of the Legally Authorized Officer on behalf of the State Scholarship Agency statement.
The original signature form must be attached to your completed form and submitted to CPS/SAIG Technical Support at
the address on page 2. A copy of each signed and dated statement must be maintained by your organization.

If you have any questions about completing your application, call CPS/SAIG Technical Support at 1-800-330-5947.
To reach a telecommunications device for the deaf (TDD/TTY), call 1-800-511-5806.

OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

State Scholarship and Grant Agency Form

Page 5

Step One: Provide the following information
1. Is this an initial application or are you changing/adding information to your Destination Point (TG
Number/Mailbox)? Check the applicable box below.
A. 
Initial application
B. 

Adding a new user for an additional Destination Point (TG Number/Mailbox) ___________

C. 

Change information for existing Destination Point/Mailbox with TG_______________
(Read instructions on page 4 carefully.)

2. What is the name of your organization? __________________________________________________
(maximum 40 characters)

3. Confirm your type of organization.


State Scholarship and Grant Agency

4. Complete the following information for the Destination Point Administrator (DPA) you wish to designate at your
organization. The DPA will be assigned a Destination Point (mailbox) with an identification number (TG number).
First Name___________________________ Last Name ___________________________________________
Business address___________________________________________________________________________
Business address___________________________________________________________________________
City__________________________________________State_________________________Zip____________
Area code/phone (_______) _______________________ Area code/fax (_______) ______________________
E-Mail Address: ___________________________________________________________________________
(maximum 70 characters)

Social Security Number_____________________________ Date of birth______________ __________ 19____
(month)

(day)

(year)

Mother’s maiden name ______________________________________________________________________

Office Use Only
Customer Number______________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

TG Number____________________________
State Scholarship and Grant Agency Form

Page 6

Step Two: Tell us about the services for which the Destination Point Administrator wishes
to enroll

5. A. Service Selection Information
Select the desired service(s)
 Automatic ISIR Processing: Residents
 Automatic ISIR Processing: Non-Residents
 ISIR Datamart Request Process
B. For which award years? (Check one or both.)




2011-2012

2012-2013

C. If ISIRs are selected, choose delivery option:
2011-2012



Daily



By request

2012-2013



Daily



By request

6. Do you want this Destination Point Administrator (DPA) to have access to NSLDS Online?


Yes



No, Go to Step Three

IMPORTANT: Only the DPA is permitted to use his or her Destination Point (TG Number/Mailbox) for online
access to NSLDS. Permission to use this Destination Point for online NSLDS access CANNOT be granted to
anyone else.
 NSLDS Online-View Only
Specify State _________________________
Indicate your job functions (check all that apply):
 Job responsibilities are 100% related to state scholarship and grant agency functions.
 Job responsibilities are less than 100% related to state scholarship and grant agency functions
 Default/Overpayment Status
 Enrollment
 Loan Forgiveness
 Other ______________________
 Comments _________________________________________________________________________

Go to Step Three

Office Use Only
Customer Number______________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

TG Number____________________________
State Scholarship and Grant Agency Form

Page 7

Step Three
Agency Participation Agreement
If you wish to receive electronic Institutional Student Information Record (ISIR) data, you must complete this Agreement
and by doing so you agree to obtain a signed release of information from the student prior to requesting the application
record from the Central Processing System (CPS).
Since many States have programs which provide financial assistance to students attending institutions of higher education,
and applicants for Federal student financial assistance generally also apply for assistance under such State programs, the
administration of such State programs would be greatly assisted if selected data received or generated by the U.S.
Department of Education concerning applicants for Federal student aid were provided to the Agencies administering those
programs.
The Secretary of Education is willing to assist States in the administration of their student aid programs by providing them
selected data in accordance with relevant provisions of the Privacy Act (5 U.S.C. 552a) as long as such Agencies use that
data for limited specified purposes and safeguard the confidentiality of the information provided.
Therefore, in order to facilitate the awarding of financial assistance to students attending institutions of higher education
under State financial assistance programs, and to coordinate the awarding of such assistance with financial assistance
provided by the Federal government under the Higher Education Amendments of 1992 (Pub. L. 102- 325), the Secretary
of Education (hereinafter referred to as the Secretary) will agree to furnish in accordance with relevant provisions of the
Privacy Act to

_____________________________________________________________________________________
(Name of State Scholarship and Grant Agency administering higher education student financial aid program)

____________________________________________________________________________________________
(Location)
(hereinafter referred to as Agency), on a periodic basis, the data set forth in Article I of this Agreement, with regard to
persons applying for Federal student aid under the conditions set forth in Articles II and III of this Agreement.

Office Use Only
Customer Number______________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

TG Number____________________________
State Scholarship and Grant Agency Form

Page 8

Article I
1.

The furnishing of data described in paragraph 2 of this Article has been established as a “routine use” under the
provisions of the Privacy Act by publication in the Federal Register of August 3, 2011 (18-11-01). The data
described in Paragraph 3 of this Article with respect to a given applicant will be furnished only upon the express
written consent of that applicant. Prior to disseminating any records, the Secretary will make reasonable efforts to
be assured that the records to be furnished are accurate, complete, timely, and relevant (5 U.S.C. 552(e) (6)).

2.

The data that will be furnished by the Secretary for all applicants residing, or applying for assistance, in the State
of ___________________, include: the name of the Federal student aid applicant and that applicant’s address,
Social Security Number, date of birth, dependency status, year in school, the applicant’s Expected Family
Contribution, and the Department of Education’s assigned institution number for the institution(s) of higher
education which the applicant has indicated an interest in attending.

3.

The data that will be furnished by the Secretary upon the expressed written request of those applicants residing, or
applying for assistance, in the State of_________________ include all the information contained in the “Free
Application for Federal Student Aid” (FAFSA).

Article II
1.

The Agency may use the data furnished to it under this Agreement only with regard to the administration of a
State’s and the Federal government’s programs of financial assistance to students in institutions of higher
education.

2.

The Agency shall take all steps necessary to safeguard the confidentiality of the data received. The Agency may
provide access and may release such data only to those personnel of the Agency who are specifically authorized
by the Agency to receive and review that data in connection with the application for and receipt of financial aid for
postsecondary education provided or administered by the Agency.

3.

For purposes of this Agreement, “administration” includes calculation of State student financial aid awards,
research necessary for the proper administration of the State program, and verification of data provided by the
applicant on State student aid applications. The Agency may, however, release to the public statistical summary
data obtained from the information furnished by the Secretary, provided that the identity of individual Federal
student aid applicants cannot be ascertained from such summary data.

4.

The Agency agrees to comply with all provisions of the Higher Education Act of 1965, as amended.

Article III
1.

This Agreement shall remain in force until terminated by the Agency or the Secretary. The expiration of this
Agreement shall not, however, affect the obligations incurred by the Agency under this Agreement.

2.

If the Secretary finds that there has been a failure to comply with this Agreement, the Agency shall, upon the
request of the Secretary, return all the data under this Agreement and copies made of such data. Furthermore, the
Secretary may terminate this Agreement or take such other action as may be necessary and appropriate to protect
the interest of the United States and the Title IV, HEA Federal student aid applicants.

Go to Step Four

Send this form as instructed
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

Office Use Only
State Scholarship and Grant Agency Form

Customer Number________________________
TG Number_____________________________

Page 9

Step Four: Responsibilities of the Primary and Non-Primary Destination Point
Administrators
Each Destination Point Administrator (DPA) must read, sign, and submit this statement (with original signatures) and must
keep a copy for the organization’s records.
1.

2.

Responsibilities of the Primary Destination Point Administrator (Primary DPA) and the Non-Primary DPA:


Must ensure that SAIG computing resources are used only for official government business.



Must ensure that a substantially established relationship with the applicant is in place (e.g., the applicant is a resident of
the state, has applied for admission to an institution in that state, or the applicant has provided written permission to the
state) before accessing Federal Student Aid systems to obtain privacy protected information about the student.



Must maintain a profile within the EDconnect software unless the organization uses TDClient. (See the EDconnect Help
Text for instructions on how to create and maintain these profiles. See Attachment B of the SAIG Enrollment Form for
the User Statement.)



Only the DPA listed in Step One, Question 4, page 6 is permitted to sign up and use the National Student Loan Data
System (NSLDS) as indicated in Question 6, page 7.



Must use software provided by the Department to monitor SAIG mailbox activity. This software will keep track of who is
using the Destination Point (TG Number/Mailbox), what information is being used, the date and time, and the batch
number (if applicable).



By applying for access to Federal Student Aid systems, must consent to monitoring, recording, and auditing, and
acknowledge that information gained in this manner may be disclosed by the Department to an appropriate third-party
(e.g., law enforcement personnel).



Must ensure that all Federal Student Aid applicant information is protected from access by or disclosure to unauthorized
personnel. In the event of an unauthorized disclosure or breach of applicant information or other sensitive information
(such as personally identifiable information), the DPA must notify Federal Student Aid immediately.



Must ensure that password sharing, the sharing of system access, and the use of any tools that allow access to the SAIG
are strictly prohibited. (These tools are called “authenticators.”)



Must ensure that access is provided only to systems, networks, data, control information, and software for which the DPA
is authorized.



Must ensure that procedures for sanitizing stored information are followed (e.g., overwriting disks that contain sensitive
information before reuse).



The Non-Primary (DPA) must inform the organization’s Primary DPA when access to a Federal Student Aid system is no
longer required (i.e. the individual is leaving a position or his or her job responsibilities have changed).

Additional Requirements of the Primary Destination Point Administrator (Primary DPA):


Must ensure that all users, whether DPAs or other authorized users, are aware of and are in compliance with all of the
requirements of a DPA.



Must maintain copies of all SAIG enrollment documents submitted to the Department, including the signed
“Responsibilities of the Primary and Non-Primary Destination Point Administrators” form for all DPA’s and the
certification signed by the organization’s CEO.



Must maintain a signed User Statement (see Attachment B) for anyone who is not a DPA but has access to Federal
Student Aid systems, including by batch or online.



Must review SAIG user reports provided by the Department to update user access rights.

OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

Office Use Only
Customer Number__________________________
State Scholarship and Grant Agency Form

TG Number_______________________________

Page 10

3.



At least on an annual basis, must monitor the organization’s NSLDS user access by creating reports using the NSLDS
Web site.



Must ensure that the organization has a process to inform the Primary DPA of any changes in a user’s need for access to
Federal Student Aid systems because of changes to job responsibilities or termination of employment. The Primary DPA
must immediately deactivate or delete user access rights for organization employees who no longer require access.

Agreements
The Primary DPA and/or the Non-Primary DPA agree(s) and understand(s) that intentional submission of false or misleading
information to the U.S. Department of Education is subject to a fine of up to $10,000, imprisonment for up to five years, or
both, under provisions of the United States Criminal Code (including 18 U.S.C. 1001). The Primary DPA and/or the NonPrimary DPA also agree(s) to comply with all provisions of Section 483 of the Higher Education Act of 1965, as amended.

4.

Privacy Act Statement
We use the information that you provide on this form to enroll your institution and users for services with Federal Student Aid
systems.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM AND DISCLOSURE OF SOCIAL SECURITY
NUMBERS:
Title IV of the Higher Education Act of 1965, as amended (HEA); 20 U.S.C. 1070 et seq. Section 31 U.S.C. 7701 and
Executive Order 9397 (November 23, 1943), as amended by Executive Order 13478 (November 18, 2008) authorize the
collection of Social Security Numbers of users of this system. The Social Security Number is voluntary in order to identify
individuals for Federal purposes, but you will not be provided with access to or use of the system if you do not provide a
Social Security Number. Collection of the Social Security Number is authorized consistent with Executive Order 12549
(February 18, 1986), 20 U.S.C. 1082 and 1094 et seq. for the purpose of identifying debarred individuals.
PURPOSE(S):
The information in this system is maintained for the purposes of: (1) Processing stored data from the SAIG Enrollment Forms
(Web and paper versions); (2) maintaining the SAIG Enrollment Web site (titled FSAWebEnroll.ed.gov); (3) managing the
assignment of individual electronic SAIG mailbox numbers, known as ‘‘TG numbers’’; and (4) authenticating users of the
CPS Online, eCB System, NSLDS Online, COD System, FMS, DMCS, Federal Loan Servicers, and AIMS.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES: The Department may disclose information contained in a record in this system of
records under the routine uses listed in the system of records notice, which was published on April 19, 2010 (75 Fed. Reg.
20346-20350) http://edocket.access.gpo.gov/2010/2010-8959.htm without the consent of the individual if the disclosure is
compatible with the purposes for which the record was collected. These disclosures may be made on a case-by-case basis or,
if the Department has complied with the computer matching requirements of the Privacy Act of 1974, as amended (Privacy
Act), under a computer matching agreement.
(1) Program disclosures. The Department may disclose records maintained in the SAIG, Participation Management System
for the purpose of allowing authorized users who are eligible to participate in the electronic exchange of data with the
Department to transmit files to and from the following Department databases and access the Department's Web sites online,
based on the approved program functions of each of the Department's systems that include, but are not limited to the
following:
(a) COD System;
(b) CPS, under the Federal Student Aid Application File;
(c) eCB System;
(d) NSLDS;
(e) FMS;
(f) DMCS, under Common Services for Borrowers (CSB);
(g) Federal Loan Servicers; and
(h) AIMS.
(2) Freedom of Information Act (FOIA) advice disclosure. The Department may disclose records to the Department of
Justice (DOJ) and the Office of Management and Budget if the Department seeks advice regarding whether records
maintained in the system of records are required to be released under the FOIA and the Privacy Act of 1974.

OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

Office Use Only
Customer Number__________________________
State Scholarship and Grant Agency Form

TG Number_______________________________

Page 11

(3) Disclosure to the DOJ. The Department may disclose records to the DOJ to the extent necessary for obtaining DOJ
advice on any matter relevant to an audit, inspection, or other inquiry related to the programs covered by this system.
(4) Contract disclosure. If the Department contracts with an entity for the purposes of performing any function that requires
disclosure of records in this system to employees of the contractor, the Department may disclose the records to those
employees. Before entering into such a contract, the Department shall require the contractor to maintain Privacy Act
safeguards as required under 5 U.S.C. 552a(m) with respect to the records in the system.
(5) Litigation and Alternative Dispute Resolution (ADR) disclosures. In the event of specified litigation or ADR, if the
Department determines that disclosure of records to the DOJ, or attorneys engaged by DOJ, an adjudicative body before
which the Department is authorized to appear, an individual or entity designated by the Department or otherwise empowered
to resolve or mediate disputes, a party, counsel, representative or witness in an administrative proceeding is relevant and
necessary to the litigation, the Department may disclose those records as a routine use to any of the foregoing individuals or
entities.
(6) Research disclosure. The Department may disclose records to a researcher if an appropriate official of the Department
determines that the individual or organization to which the disclosure would be made is qualified to carry out specific
research related to functions or purposes of this system of records. The official may disclose records from this system of
records to that researcher solely for the purpose of carrying out that research related to the functions or purposes of this
system of records. The researcher shall be required to maintain Privacy Act safeguards with respect to the disclosed records.
(7) Congressional Member disclosure. The Department may disclose records to a member of Congress from the record of
an individual in response to an inquiry from the member made at the written request of that individual. The
Member’s right to the information is no greater than the right of the individual who requested it.
(8) Disclosure for use by Law Enforcement Agencies. The Department may disclose information to any Federal, State,
local or other agencies responsible for enforcing, investigating, or prosecuting violations of administrative, civil, or criminal
law or regulation if that information is relevant to any enforcement, regulatory, investigative or prosecutorial responsibility
within the entity’s jurisdiction.
(9) Enforcement disclosure. In the event that information in this system of records indicates, either on its face or in
connection with other information, a violation or potential violation of any applicable statute, regulation, or order of a
competent authority, the Department may disclose the relevant records to the appropriate agency, whether foreign, Federal,
State, tribal, or local, charged with the responsibility of investigating or prosecuting that violation or charged with enforcing
or implementing the statute, Executive Order, rule, regulation, or order issued pursuant thereto.
(10) Employment, benefit, and contracting disclosure. The Department may disclose records to a Federal, State, or local
agency maintaining civil, criminal, or other relevant enforcement or other pertinent records, or to another public authority or
professional organization, if necessary to obtain information relevant to a Departmental or receiving entity’s decision
concerning the hiring or retention of an employee or other personnel action, the issuance of a security clearance, the letting of
a contract, or the issuance of a license, grant, or other benefit.
(11) Employee grievance, complaint or conduct disclosure. The Department may disclose records to another agency of
the Federal Government if the record is relevant to one of the following proceedings regarding a present or former employee
of the Department: complaint, grievance, discipline or competence determination proceedings. The disclosure may only be
made during the course of the proceeding.
(12) Labor organization disclosure. The Department may disclose records to an arbitrator to resolve disputes under a
negotiated grievance procedure or to officials of labor organizations recognized under 5 U.S.C. chapter 71when relevant and
necessary to their duties of exclusive representation.

OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

Office Use Only
Customer Number__________________________
State Scholarship and Grant Agency Form

TG Number_______________________________

Page 12

PRIMARY AND NON-PRIMARY DPA RESPONSIBILITIES:
The information provided to the Primary and Non-Primary DPA by the U.S. Department of Education is protected by the
Privacy Act of 1974, as amended. Protecting this information, once it is entrusted to the Primary and Non-Primary DPA,
becomes his or her responsibility. Therefore, the Primary and Non-Primary DPA agree to protect the privacy of all
information that has been provided by the U.S. Department of Education. The Primary and Non-Primary DPA understand that
any person, including himself or herself, who knowingly and willfully requests or obtains any record concerning an individual
from an agency under false pretenses shall be guilty of a misdemeanor and is subject to a fine of up to $5,000 (5 U.S.C.
552a(i)(3)).
Without the information provided on the SAIG enrollment form, a Participating entity would be denied access to
electronically transmit reports and data via the SAIG and would be denied access to all Web sites affiliated with this
agreement as appropriate.

Non-Primary Destination Point Administrator’s name_________________________________________________________
(Printed name)

Signature_________________________________________________________Date_______________________________
(Must match name in Question 4 - original signature must be submitted)

Primary Destination Point Administrator’s Name ____________________________________________________________
(Printed name)

Signature ____________________________________________________________________________________________

Sign and send this form as instructed
Go to Step Five

Office Use Only
Customer Number______________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

TG Number___________________________________
State Scholarship and Grant Agency Form

Page 13

Step Five: Certification of the Legally Authorized Officer on behalf of the State
Scholarship Agency
1.

Responsibilities of the President/CEO
As the President/CEO you certify that:
• The name of every person who is a SAIG DPA is included in this application (or is already on file with the SAIG),
• You will immediately notify CPS/SAIG Technical Support in writing when any person no longer serves as a designated
authorized official or the Primary or Non-Primary DPA,
• You will not permit unauthorized use or sharing of SAIG passwords or codes that have been issued to you or to anyone
else in your organization,
• Each person who is a SAIG DPA for your agency has read and understood the responsibilities in Step Three,
• Each person who is a SAIG DPA for your agency has signed a copy of “Step Four: Responsibilities of the Primary and
Non-Primary DPAs” and that a copy of Step Four with an original signature has been sent to us, and
• Each person who is a SAIG DPA for your agency has made a copy of the signed Step Four document for his or her own
files.
• Our organization has provided security due diligence and will hire and allow only trustworthy staff to access Federal
Student Aid (FSA) data. As a Department of Education Partner, I certify this individual to be trustworthy.

State Scholarship and Grant Agency Representative
_________________________________________ ________________________________________________
(Printed name)

(Printed title - Required)

Signature _______________________________________________________ Date___________________________
(Original signature must be submitted)

Name of Agency _________________________________________________________________________________

U.S. Department of Education authorizing signature:
Signature________________________________________________
Print Name_______________________________________________

Sign and send this form as instructed

Office Use Only
Customer Number______________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

TG Number___________________________________
State Scholarship and Grant Agency Form

Page 14

Attachment A: Glossary
Award Year. July 1 of one year through June 30 of the next year. For the Grant Services (Pell, Iraq Afghanistan Service
Grant, ACG, SMART, and TEACH), and the electronic Campus-Based (eCB) Programs systems, eligible students
are paid out of funds designated for a particular award year.
Central Processing System (CPS). The CPS manages the application and eligibility determination portion of the federal
student aid process. It gathers information from applicants via the Free Application for Federal Student Aid
(FAFSA), applies computerized edits and calculations to determine the student’s eligibility, and communicates the
results to the students, schools, state agencies, third-party servicers, and other federal computer systems.
Destination Point. An electronic mailbox that sends and receives financial aid data using the SAIG. Every Destination
Point is administered by a Primary or Non-Primary Destination Point Administrator (DPA) and has an electronic
mailbox number that begins with the letters “TG.” (See Destination Point Administrator.)
Destination Point Administrator (DPA). An individual representing an organization involved in the administration of Title
IV, HEA student financial aid programs (such as a postsecondary institution, Federal Family Education Loan
Program (FFELP) Lender, FFELP Guaranty Agency or third-party servicer) that is enrolled in the SAIG and
assigned a Destination Point. To enroll as a DPA, an organization’s representative must complete and submit for
processing the SAIG Enrollment Form to participate in the U.S. Department of Education’s Student Aid Internet
Gateway. The DPA is responsible for the SAIG users’ access to Federal Student Aid systems, to ensure the data
provided by these systems is protected according to the Privacy Act of 1974, as amended, as well as to ensure
users do not inappropriately access records that are not associated with their organization. The Primary DPA is
responsible for enrolling additional Non-Primary DPAs for specific SAIG services assigned to their Destination
Points (TG Number/Mailboxes). Non-Primary DPAs are not allowed to make enrollment changes.
EDconnect. ED’s telecommunications software that allows PC Windows users to send and receive data through the SAIG.
Electronic Services. Primary Destination Point Administrators (Primary DPAs) and their Secondary Destination Point
Administrators (Secondary DPAs) for their organization may enroll users for FAA Access to CPS Online or
EDconnect Entitlement Access. An FSA User ID and password are required to log in to both systems.
Federal Loan Servicer. An entity that services Title IV, HEA loans owned by the Department of Education (the
Department). These loans include, but are not limited to, William D. Ford Federal Direct Loan (Direct Loan)
Program loans and Federal Family Education Loan (FFEL) Purchased Loans, more simply referred to as federallyowned loans. Current listings of the Department's federal loan servicers, including each servicer's contact
information, are available at the Loan Servicing Centers for Schools and Loan Servicer Centers for Students pages
on the Information for Financial Aid Professionals (IFAP) Web site.
Federal Student Aid. The 1998 Reauthorization of the Higher Education Act (HEA) established a performance-based
organization to administer the Federal Student Aid programs at the U.S. Department of Education. These
programs include Federal Grant Services (Pell, TEACH and the Iraq and Afghanistan Service Grant), FFELP
Stafford loans, Federal Direct Loans, FFELP and Direct PLUS loans, and the eCB Programs systems: Federal
Work Study, Federal Perkins loans, and Federal Supplemental Educational Opportunity grants.
Free Application for Federal Student Aid (FAFSA). The application that the student must file to apply for aid from any
Title IV, HEA program, including the Direct Loan and PLUS loan programs. Students can apply online by using
FAFSA on the Web (http://fafsa.ed.gov). The FAFSA is also printed and distributed free of charge by the U.S.
Department of Education.
Institutional Student Information Record (ISIR). The term ISIR refers to all processed student information records that are
sent electronically to institutions by the Central Processing System (CPS). The ISIR contains all information
reported on the Free Application for Federal Student Aid (FAFSA), key processing results, and National Student
Loan Data System (NSLDS) financial aid history information.
January 2012

State Scholarship and Grant Agency Form

Page 15

ISIR Datamart Request. This is a function of FAA Access to CPS Online that Destination Point Administrators can use to
request ISIRs from the CPS.
National Student Loan Data System (NSLDS). A national database of student loan-level information and selected grant
recipient data for loans and grants disbursed under the Title IV, HEA programs.
Non-Primary Destination Point Administrator (Non-Primary DPA). The Primary DPA is responsible for enrolling
additional Non-Primary DPAs for specific SAIG services assigned to their Destination Points (TG
Number/Mailboxes).Non-Primary DPAs are not allowed to make enrollment changes.
Non-resident. Students who indicate an institution on their FAFSA that is not within the student’s state of legal
residence).
Primary Destination Point Administrator (Primary DPA). An individual who has been appointed by the organization as
the responsible party for the enrollment of the organization’s additional Non-Primary DPA’s which result in the
establishment of their SAIG Mailboxes and may include FAA Access Online use. The Primary DPA is
responsible for the SAIG users’ access to Federal Student Aid systems, to ensure the data provided by these
systems is protected according to the Privacy Act of 1974, as amended, as well as to ensure users do not
inappropriately access records that are not associated with their organization. Note: The Primary DPA is
responsible for enrolling additional Non-Primary DPAs for specific SAIG services assigned to their Destination
Points (TG Number/Mailboxes).
Resident. Students who indicate an institution on their FAFSA that is within the student’s state of legal residence.
SAIG User. An individual allowed access to a Destination Point (TG Number/Mailbox) by the assigned Destination Point
Administrator (DPA). A SAIG user must read and sign a Federal Student Aid User Statement that the Primary
DPA must maintain.
Social Security Number (SSN). The number assigned to an individual by the Social Security Administration and used as
the identifying number for many Federal purposes, including identifying student financial aid program
administrators and applicants participating in the Title IV, HEA programs.
Student Aid Internet Gateway (SAIG). The SAIG links thousands of Destination Points across the United States, its
territories, and certain ED-designated foreign countries to the Higher Education Act’s Title IV, HEA student
financial aid programs and delivery system. Organizations enroll individuals as DPAs in the SAIG. DPAs are
assigned Destination Points (electronic mailboxes), for receiving and transmitting data for Federal Student Aid
systems such as NSLDS and CPS. (See Destination Point and Destination Point Administrator.)
TDClient. ED’s telecommunications software that allows Mainframe/Midrange users to send and receive data through the
SAIG.
TG Number. A TG Number is the identifier for an electronic mailbox. It is a five-digit alphanumeric number, preceded by
“TG.”
U.S. Department of Education (ED, Department). The federal agency responsible for the administration of Title IV, HEA
Federal student aid programs.

January 2012

State Scholarship and Grant Agency Form

Page 16

Attachment B: Federal Student Aid User Statement
Any individual who accesses Federal Student Aid systems and/or uses resources that access those systems, whether by batch or online,
must read and sign this statement. In addition, the Federal Student Aid User Statement must be signed by the Electronic Services User
or Non-Primary DPA, the Primary DPA, and the original must be maintained by the organization. The user should keep a copy of the
signed statement for his or her records.
The user understands that intentional submission of false or misleading information to the U.S. Department of Education is subject to a
fine up to $10,000, imprisonment for up to five years, or both, under provisions of the United States Criminal Code (including 18
U.S.C. 1001). The user also agrees to comply with all provisions of Section 483 of the Higher Education Act of 1965, as amended.
The user understands that the information provided by the U.S. Department of Education is protected by the Privacy Act of 1974, as
amended. Protecting this information, once it is entrusted to the user, becomes his or her responsibility. Therefore, the user agrees to
protect the privacy of all information provided to him or her by the U.S. Department of Education. The user understands that any
person, including himself or herself, who knowingly and willfully requests or obtains any record concerning an individual from an
agency under false pretenses, shall be guilty of a misdemeanor and is subject to a fine of up to $5,000 (5 U.S.C. 552a(i)(3)).
Appropriate Use of Federal Student Aid Systems
Appropriate uses of Federal Student Aid systems by an Electronic Services User or Non-Primary DPA (list is not exhaustive):











Must use Electronic Services computing resources only for official government business.
Must ensure that a substantially established relationship with the applicant is in place (e.g., the applicant is a resident of the state,
has applied for admission to an institution in that state, or the applicant has provided written permission to the state) before
accessing Federal Student Aid systems to obtain privacy protected information about the student.
Must know the names of the Primary DPA, the Non-Primary DPA and the Electronic Services User for each of the Destination
Points accessed and how to contact those individuals.
Must protect all Federal Student Aid systems from access by or disclosure to unauthorized personnel.
Must report immediately to the Primary DPA any security incidents, potential threats, or vulnerabilities that involve Electronic
Services or Non-Primary DPA resources.
Must report to the Primary DPA any compromise, suspected compromises, or incidents of sharing of a password or any other
authenticator.
Must access only those systems, networks, data, control information, and software for which he or she is authorized.
Must ensure that all Electronic Services information is marked according to its sensitivity and is properly controlled and stored.
Must inform the organization’s Primary DPA when he or she no longer needs access to a Federal Student Aid system (i.e., the
individual is leaving his or her position or his or her job responsibilities have changed).
Must not add code that might be harmful to the SAIG or Electronic Services.

TG#__________
DPA Name for the above TG Number _______________________________________________________
Non-Primary DPA or Electronic Services User Name ____________________________________________________
(Print)

Non-Primary DPA or Electronic Services User Job Title ______________________________________ SSN_______________
Phone # (______) ___________________
Non-Primary DPA or Electronic Services User Signature ______________________________________ Date_______________
Primary DPA Signature ______________________________________________________ Date__________________
(This statement with an original signature must be maintained by the Primary DPA.)

Do Not Submit This User Statement The Signed Original Form Must Be Retained By The Organization
OMB NO: 1845-0002
Expiration Date: 12/31/2013
January 2012

State Scholarship and Grant Agency Form

Page 17

Attachment C: Burden Statement
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless it displays a valid OMB number. The valid OMB control number of this information collection is 1845-0002
and will expire on 12/31/2013.
The time required to complete this form is estimated to average 40 minutes per initial paper application response, 20
minutes per initial web application online, 15 minutes per updated response on paper, and 10 minutes per updated
response online, including the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information collection. If you have any comments concerning the accuracy of the time
estimates or suggestions for improving this form, write to:
U.S. Department of Education
Union Center Plaza
830 First Street, N.E.
UCP-031C4
Washington, D.C. 20202

January 2012

State Scholarship and Grant Agency Form

Page 18