School Lender GA Enrollment Form

Student Aid Internet Gateway (SAIG) Enrollment Document

Att_PM_2011-2012 School Lender GA Enrollment Form_101910

School Lender GA Enrollment Form - Not-for-Profit Institutions

OMB: 1845-0002

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Student Aid Internet Gateway (SAIG)
Enrollment Form For
Postsecondary Educational Institutions,
Institutional Third-Party Servicers,
FFELP Guaranty Agencies and Guaranty Agency Servicers,
Title IV Additional Servicers (TIVAS),
FFELP Lenders and Lender Servicers

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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
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) and Primary
Destination Point (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 inactivated.

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 organization 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 student
financial aid programs.

About Enrollment
The following entities are eligible to enroll in the SAIG:
•

Postsecondary educational institutions that participate in the federal student financial aid programs authorized under
Title IV of the Higher Education Act,

•

Organizations that contract with an eligible institution to perform Title IV related functions as a third-party servicer,

•

Guaranty agencies (GAs) or their Guaranty Agency servicers that have an agreement with ED under the Federal
Family Education Loan Program (FFELP),

•

FFELP lenders or their FFELP lender servicers,

•

Title IV Additional Servicers (TIVAS), and

•

Other entities approved by ED.

If you use this form to add and change information, check Box C in Step One, Question 1 on page 13; fill in the
information that has changed for any questions in Steps One and Two; complete Steps Three and Four; and send your
application to the address below.
Application for enrollment in the SAIG (and changes to enrollment) can also be completed online at
http://www.fsawebenroll.ed.gov.

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You may photocopy this form, but you must always send us original signatures for Step Three and Step Four. 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
Available Services
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 school’s primary Destination
Point (TG Number/Mailbox). Enrollment is designed to secure the integrity of data that is exchanged between you and the
many ED systems accessed over the SAIG or online. These systems include the Central Processing System (CPS), the
Common Origination and Disbursement (COD) System, the National Student Loan Data System (NSLDS), the electronic
Campus-Based (eCB) Programs systems, the Financial Management System (FMS), the Debt Management Collection
System (DMCS), the Conditional Disability Discharge Program (CDD), the Direct Loan Servicing System (DLSS), and
FAA Access to CPS Online.
Before completing the application you should determine, based on the systems that your organization must access, the
programs or services that your organization needs to participate in, the appropriate people who need to use those services,
and the number of Destination Points (TG Number/Mailboxes) required. The Primary DPA is responsible for enrolling
additional Non-Primary DPAs for specific SAIG services assigned to their Destination Points (TG Number/Mailboxes).
The services that can be accessed over the SAIG are:
1. Central Processing System (CPS), Submission of Application (FAFSA) Data: Free Application for Federal Student
Aid (FAFSA) application data, including corrections, can be entered and submitted over the SAIG. Processed student
application data is reported to institutions on the Institutional Student Information Record (ISIR). To enroll a DPA
with access to these services, complete Step One; Step Two, Question 5; Step Three; and Step Four. Note: only one
Destination Point (TG Number/Mailbox) can be used to exchange data with each of the CPS applicant data functions
(corrections, ISIRs), except in the case of initial FAFSA applicant data. For the submission of initial FAFSA applicant
data, two Destination Points are permitted. See table below.
2. Federal Grant Services: All participants in the Federal Pell Grant (Pell Grant) Program, the Iraq Afghanistan Service
Grant program, the Academic Competitiveness Grant (ACG) program, the National Science and Mathematics Access
to Retain Talent Grant (National SMART Grant) program, and the Teacher Education Assistance for College and
Higher Education (TEACH) Grant Program must transmit origination and disbursement data over the SAIG to the
Common Origination and Disbursement (COD) system. To enroll for this service, complete Step One; Step Two,
Question 7; Step Three; and Step Four.
3. Federal Direct Loan (Direct Loan) Program: The Common Origination and Disbursement (COD) system also allows
Direct Loan program origination, disbursement, and other required reporting information to be exchanged
electronically through the SAIG. To enroll for this service, complete Step One; Step Two, Question 6; Step Three;
and Step Four.
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4. electronic Campus-Based (eCB) Programs systems: The eCB Programs systems include Federal Work-Study (FWS),
the Federal Supplemental Educational Opportunity Grant (FSEOG), and the Federal Perkins Loan program. The
application method for enrolling and participating in one or all of the eCB programs is the Fiscal Operations Report
and Application to Participate (FISAP). The annual submission deadline for the FISAP is October 1. To enroll for this
service, complete Step One; Step Two, Question 8; Step Three; and Step Four.
5. National Student Loan Data System (NSLDS): NSLDS is a national database that collects and maintains individual
student data for all Title IV student loan borrowers and grant recipients. All institutions that participate in the Title IV
student financial aid programs must have at least one Destination Point (TG Number/Mailbox) for NSLDS services
that includes the online Enrollment Reporting (formerly SSCR) function for updating student enrollment data,
Transfer Student Monitoring (TSM), overpayment update, and batch services for Cohort Default Rate (eCDR). You
may also request online NSLDS access to view and update Title IV loan, grant, and enrollment history information.
To enroll a DPA with a Destination Point for these services:
•

Postsecondary Educational Institutions and Institutional Servicers must complete Step One; Step Two, Section 1,
Questions 9, 10, and 11; Step Three; and Step Four.

•

FFELP Guaranty Agencies and Guaranty Agency Servicers must complete Step One; Step Two, Section 2,
Questions 16 and 17; Step Three; and Step Four.

•

FFELP Lenders and Lender Servicers must complete Step One; Step Two, Section 3, Question 19; Step Three;
and Step Four.

6. Financial Management System (FMS): The Lender Reporting System (LaRS) allows FFEL Program lenders or their
servicers the option of sending financial reporting information to Federal Student Aid’s Financial Management
System (FMS) using their SAIG mailbox. To enroll for this service, complete Step One; Step Two, Section 3,
Question 18; Step Three; and Step Four. The Guaranty Agency Financial Reporting (GAFR) allows Guaranty
Agencies the option of sending financial reporting information to Federal Student Aid’s Financial Management
System (FMS) using their SAIG mailbox. To enroll for this service, complete Step One; Step Two, Section 3,
Question 15; Step Three; and Step Four.
7. Direct Loan Servicing System (DLSS): The Direct Loan Borrower Delinquency Report is sent monthly to all Direct
Loan institutions enrolled with the Student Aid Internet Gateway. It contains a list of delinquent/defaulted Direct
Loans administered by the specified institution. Guaranty Agencies that want to enroll for Borrower Services must
complete Step One; Step Two, Section 2, Question 14; Step Three; and Step Four.
8. Debt Management Collection System (DMCS): The Debt Management Collection System (DMCS) houses all
Federal Student Aid held default debt. This includes FFELP loans assigned from Guaranty Agencies, Program
Overpayments, Perkins loans assigned from schools, and all the Direct Loan program defaults. The system also
interfaces with other government agencies such as Treasury for the Treasury Offset Program (TOP), Health and
Human Services for access to CAIVERS and the National Database of New Hires (NDNH). To enroll for this
service, complete Step One; Step Two, Question 12; Step Three; and Step Four.
9. Conditional Disability Discharge (CDD) Program: The Conditional Disability Discharge (CDD) Program was created
to support the regulatory requirement to track borrower claims for total and permanent disability discharge for three
years. The regulations require monitoring of income and loan status for a period of three years after certification of
disability by a physician. Borrowers determined to be ineligible after the three-year period will be returned to active
servicing status. However, if the borrower still meets the eligibility criteria at the end of this period, final discharge of
student loan is granted. Guaranty Agencies that want to enroll for Borrower Services must complete Step One; Step
Two, Section 2, Question 14; Step Three; and Step Four.

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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 DPA’s Destination Point (Mailbox) on the SAIG. The TG number will be sent to the new DPA upon
successful processing of the enrollment form.
The Primary DPA may enroll more than one Non-Primary DPA with a separate Destination Point (TG Number/Mailbox)
for each service or function, or choose to combine all non-NSLDS Online services and functions through a single
Destination Point (TG Number/Mailbox). The number of Destination Points allowed per institution for each function is
provided in the following table:

Services

Number of Destination
Points allowed per
institution

Central Processing System (CPS), Submission of Application (FAFSA) Data

Two

CPS, All Other Functions/Types

One

Grant Services for Pell Grant, Iraq Afghanistan Service Grant, Academic
Competitiveness Grant (ACG), National Science and Mathematics Access to Retain
Talent Grant (National SMART Grant) and the Teacher Education Assistance for
College and Higher Education (TEACH) Grant Processing/Batch Files

One

Direct Loan Program (All)

One

electronic Campus-Based (eCB) Programs systems, FISAP

One

FFELP and Direct Loan Cohort Default Rate Packages, Batch

One

National Student Loan Data System (NSLDS) Batch Files

One

NSLDS Online

No Limit

Financial Management System (FMS), Lender Reporting System (LaRS) and Guaranty
Agency Financial Reporting (GAFR)

One

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 Four). 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.

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To complete the SAIG enrollment application, you may 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://www.fsawebenroll.ed.gov/PMEnroll/PMAccountServlet.jrun, provide identifying
information, 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.

•

Postsecondary institutions will need their OPE-ID number. If your school participates in the Grant Services and/or
Direct Loan Program, you will also need the institution’s Federal School Code and/or Direct Loan Program code. To
find these numbers, look at the reports your school has submitted for these programs in the past, such as your
organization’s Eligibility and Certification Report (ECAR), and Program Participation Agreement (PPA). You can
also call ED’s School Eligibility Channel at 1-202-377-4277.

•

Guaranty agencies will need the Guaranty Agency (GA) code number assigned by ED. A list of active and inactive
GA codes is contained in the instructions for the Guaranty Agency Financial Report -- Form 2000 accessible at
http://www.fp.ed.gov.

•

Lenders and Servicers will need the Lender ID (LID) or Lender/Servicer ID number assigned by ED. Participating
lenders will find their Lender ID numbers on the Lender Application Process or LaRS forms accessible at
http://www.fp.ed.gov.

•

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.,
Coralville, IA 52241. You may also cancel online at http://www.fsawebenroll.ed.gov.

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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, including a newly eligible postsecondary educational institution (school),
an institutional third-party servicer, or an FFELP lender that has never used the SAIG. You can also use the
enrollment form to change or to add information about an existing DPA or Destination Point (TG
Number/Mailbox), and to add Destination Points for an organization that is already enrolled.
A. Check the box for “initial application” if you are a first-time participant and your organization does not have a TG
number.
B. Check the box 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 the box 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 Step One; and complete Steps 3
and 4.
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.

Check the appropriate box to indicate the type of organization.

4.

•

Postsecondary educational institutions (schools) must fill out Step Two, Section 1.

•

Institutional third-party servicers must fill out Step Two, Section 1.

•

Guaranty agencies for FFELP student loans must fill out Step Two, Section 2.

•

Guaranty agency servicers for FFELP student loans must fill out Step Two, Section 2.

•

Title IV Additional Servicers (TIVAS) must fill out Step Two, Section 2.

•

Lenders for FFELP student loans must fill out Step Two, Section 3.

•

Lender servicers for FFELP student loans must fill out Step Two, Section 3.

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 email address.

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Step Two
•

Postsecondary educational institutions and institutional third-party servicers go to Step Two, Section 1 for
instructions.

•

FFELP guaranty agencies and guaranty agency servicers go to Step Two, Section 2 for instructions.

•

Title IV Additional Servicers (TIVAS) go to Step Two, Section 2 for instructions.

•

FFELP lenders and lender servicers go to Step Two, Section 3 for instructions.

Step Two, Section 1 is for Postsecondary Educational Institutions and Institutional Servicers only
In Section 1 you will choose the services for which your institution requires enrollment.
5. A. If the DPA you are enrolling or for whom you are adding or changing services will be sending and receiving
student applicant data (FAFSAs and ISIRs), complete all required information including the Federal School Code.
If this enrollment is for a DPA that will not be involved in CPS applicant data transmissions, go to Question 6.
B. Check the boxes for the award year(s) this DPA should receive the applicant data you check in Question 5-C.
C. Check the boxes for the CPS applicant data function you want this DPA to receive and submit. If you are
completing this form to update or change services for an enrolled DPA, provide the TG number of the Destination
Point already assigned to this DPA.
D. Choose the preferred delivery option for ISIRs, if ISIRs are selected in Question 5-C. Postsecondary institutions
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.
E. If your school uses a third-party servicer to submit batch files to CPS, but also wishes to access CPS Online tools
(such as FAA Access to CPS Online and Return of Title IV Funds [R2T4] on the Web), check the Yes box to
designate yourself as the Destination Point (TG Number/Mailbox) for CPS Online services for the school
selected. Note: ONLY select this option if your institution utilizes a third-party servicer to submit batch services
to CPS, and you want access to CPS Online tools such as FAA Access to CPS Online and Return to Title IV. If
you need access for additional financial aid staff for CPS Online tools, you may enroll them under Enroll FAA
Users for Online Services at http://www.fsawebenroll.ed.gov.
6.

If your organization participates in the Direct Loan Program and the DPA identified in Question 4 will be
assigned to submit and receive Direct Loan Program data, identify the years that the DPA in Question 4 will need
to access Direct Loan data. Also, provide the school’s Direct Loan code. If the DPA is already enrolled and you
are only updating information for that DPA, provide the TG number for that DPA’s Destination Point (TG
Number/Mailbox).

7.

If you want this Destination Point (TG Number/Mailbox) to receive and submit Grant Services (Pell, Iraq
Afghanistan Service Grant, ACG, SMART, and TEACH*) Payment data, then complete Question 7. *Note: If
your institution is a two- or four-year, degree-granting institution, you will submit and receive payment data under
the Grant Services enrollment. No separate enrollment for Iraq Afghanistan Service Grant, ACG, National
SMART Grant, or TEACH Grant is needed.

8.

If you participate or expect to participate in the Federal Work-Study, Federal Supplemental Educational
Opportunity Grant (FSEOG), and/or Federal Perkins Loan program(s), and the DPA for whom you are
completing this enrollment form will be administering the Destination Point (TG Number/Mailbox) for the
FISAP, complete Question 8. Otherwise, go to Question 9.

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If you currently participate in any of the eCB programs, provide your Title IV OPE-ID number. You will find the
OPE-ID number on your most recent FISAP report. Next, provide the TG number of the Destination Point
Fill in the name of the school. If the address of the school has not already been provided in Question 4, provide all
the requested address information.
NOTE: All DPAs enrolled for any of the eCB Programs systems must also register online for access to the eCB
Programs systems and establish an FSA User ID and password. To obtain an FSA User ID, go to
https://cbfisap.ed.gov, click on the "Login" button and select “eCB Registration”, provide identifying information,
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.
The Primary DPA is responsible for approving other users who wish to access your institution’s data on the eCB
Programs systems. You will receive an e-mail when a school user attempts to register for access to your
institution’s data. To review and process the access request, log in to https://cbfisap.ed.gov.
9. A. As the Primary DPA, you must identify the DPA enrolling to receive batch file data from NSLDS, complete
Question 9.
B. In Question 9-B, check the boxes for the batch files you want this DPA to receive. If this DPA already has a
Destination Point (TG Number/Mailbox), provide the TG number here. Provide the date on which this DPA will
begin responsibility for the sending or receiving of NSLDS data. Indicate whether this DPA’s Destination Point
(TG Number/Mailbox) will receive Transfer Student Monitoring data, Enrollment Reporting files (formerly
SSCR), and/or Federal Perkins Loan data. Select Transfer Student Monitoring if you want the DPA to send and
receive Financial Aid History/Transfer Student Monitoring data.
10.

As the Primary DPA, you must identify the DPA you want to enroll for electronic Cohort Default Rate
Notification packages (eligibility letter and loan record detail report) from NSLDS. Your main campus (OPE-ID
ending in ‘00’) must sign up for this service.

11.

As the Primary DPA, you must identify the DPA you want to enroll for online access to student data available on
NSLDS, check the boxes to indicate the specific information type(s) for this DPA to access.
IMPORTANT: Only the DPA is permitted to use his or her Destination Point (TG Number/Mailbox) for
access to NSLDS Online information. NSLDS Online users CANNOT share their NSLDS access with
anyone else.
Online Default Services automatically given to users are:
Loan History
Federal Grants History
Enrollment History
Overpayment History
Organization Contacts

Enrollment Reporting
Data Provider Schedules
Online Reports
Transfer Student Monitoring
Foreign School Reporting

If this DPA will access information for a school as its third-party servicer, provide the school’s name and OPE-ID
number. NOTE: Authorizing Officials’ signatures (Step Four) are required from both the school and the
third-party servicer before access will be granted.
12.

If your organization participates in the Direct Loan Program and the DPA identified in Question 4 will be
assigned to receive the Direct Loan Borrower Delinquency Report, provide the school’s Direct Loan code. If the
DPA is already enrolled and you are only updating information for that DPA, provide the TG number for that
DPA’s Destination Point.

Go to Step Three
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Step Two, Section 2 is for FFELP Guaranty Agencies(GAs), Guaranty Agency (GA) Servicers and
TIVAS only
In Section 2 you will choose the services for which your organization requires enrollment.
13. A. As the Primary DPA, you must identify the DPA you want to enroll for student applicant data (ISIRs), and
complete all required information including the State for which you will be receiving ISIR data. Note: Guaranty
Agencies (GAs) must have prior approval from Federal Student Aid to receive ISIR data. This is not applicable
for TIVAS.
B. Choose the service for which you are enrolling.
C. Check the boxes for the award years this DPA should receive the applicant data.
D. Choose the preferred delivery option for ISIRs if ISIRs are selected in Question 13-B. 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.
14.

As the Primary DPA, you must identify the DPA you want to enroll for Borrower Services (includes Treasury
Offset Process (TOP), Mandatory Assignment Process, National Directory of New Hires (NDNH), IRS Skip
Trace, and Conditional Disability Discharge (CDD), complete Question 14.

15.

As the Primary DPA, you must identify the DPA you want to enroll for Guaranty Agency Financial Reporting
(GAFR), complete Question 15. This is not applicable for TIVAS.

16. A. As the Primary DPA, you must identify the DPA you want to enroll for batch file data from NSLDS, complete
Question 16.
B. In Question 16-B, check the boxes for the batch files you want this DPA to receive. If this DPA already has a
Destination Point (TG Number/Mailbox), provide the TG number here. Provide the date on which this DPA will
begin responsibility for the sending or receiving of NSLDS data. Indicate whether this DPA’s Destination Point
will receive GA Loan data, Loan Processing and Issuance Fee (LPIF) back-up detail, Account Maintenance Fee
(AMF) back-up detail, or Annual Reasonability back-up detail. (LPIF, AMF, and Annual Reasonability are not
applicable to TIVAS.)
17.

As the Primary DPA, you must identify the DPA you want to enroll for online access to student data available on
NSLDS, check the boxes to indicate the specific information type(s) you want this DPA to access.
IMPORTANT: Only the DPA is permitted to use his or her Destination Point (TG Number/Mailbox) for
access to NSLDS Online information. NSLDS Online users CANNOT share their NSLDS access with
anyone else. NSLDS Online access is permitted for FSA authorized uses only.
Online Default Services automatically given to users are:
Loan History
Enrollment Reporting
Data Provider Schedules
Enrollment History
Organization Contacts
Various Online Reports
GA/TIVAS Online Loan Update (includes Teacher Loan Forgiveness/Loan Discharge)– this service allows
NSLDS Online users to update individual loans on an ad hoc basis and update loan data for students who are
granted Teacher Loan Forgiveness (TLF) and Loan Discharge benefits for Title IV loans. NSLDS limits the
number of users that can sign up for this online service.
Teacher Loan Forgiveness/Loan Discharge (only) –this service allows NSLDS Online users to update loan data
for students who are granted Teacher Loan Forgiveness (TLF) and Loan Discharge benefits for Title IV loans.
NSLDS limits the number of users that can sign up for this online service.
Select either GA/TIVAS Online Loan Update (includes Teacher Loan Forgiveness/Loan Discharge) or
Teacher Loan Forgiveness/Loan Discharge, but not both.
A. If the DPA will access information for a GA as its third-party servicer, provide the GA’s name and GA Code.
NOTE: Authorizing Officials’ signatures (Step Four) are required from both the GA and the GA servicer
before access will be considered for approval.

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B. Select all functions performed by the DPA. Select Other and provide an explanation for duties not already
described.
Go to Step Three

Step Two, Section 3 is for FFELP Lenders and Lender Servicers only
In Section 3 you will choose the services for which your lender requires enrollment.
18.

As the Primary DPA, you must identify the DPA you want to enroll for batch file data from the quarterly Lender
Reporting System (LaRS), complete Question 18.

19.

As the Primary DPA, you must identify the DPA you want to enroll for NSLDS Online access to student data.
Check the boxes to indicate the specific information type(s) you want this DPA to access.
IMPORTANT: Only the DPA is permitted to use his or her Destination Point (TG Number/Mailbox) for
access to NSLDS Online information. NSLDS Online users CANNOT share their NSLDS access with
anyone else. NSLDS Online access is permitted for FSA authorized uses only.
Online Default Services automatically given to users are:
Loan History
Enrollment History

Organization Contacts
Various Online Reports

A. If the DPA will access information for a FFELP lender as its third-party servicer, provide the lenders name and
LID Number. NOTE: Authorizing Officials’ signatures (Step Four) are required from both the lender and
the lender servicer before access will be considered for approval.
B. Select all functions performed by the DPA. Select Other and provide an explanation for duties not already
described.
Go to Step Three

OMB NO: 1845-0002
Expiration Date: 12/31/2013
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Step Three – must be completed by all applicants
Step Three collects the required agreements from the DPA identified in Step One.
Each DPA must read and sign this 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. When we receive all
necessary signatures from you, we will process your enrollment. If your enrollment was for a new TG number, we
will send your SAIG TG number to you.

Step Four – must be completed by all applicants
Step Four collects the required authorization from your organization to process the enrollment information for the DPA
you have identified in Step One.
If the President, CEO, or equivalent person wishes to designate another person to be the responsible authorizing official,
then Section 1 must be completed. This designation needs to be completed only once.
For each Destination Point (TG Number/Mailbox), the chief officer of the organization (President, CEO, equivalent
person, or designee) must sign Section 2, the responsibility statement.
If you are a third-party servicer acting on behalf of another organization, both the organization’s chief officer and your
chief officer must sign. This means both Box 2 and Box 3 in Section 2 must be completed.
The original signature form must be attached to your completed form and submitted to the SAIG at the address on page 3.
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
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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)?
A.

initial application

B.

adding a new user for primary Destination Point (TG Number/Mailbox) ___________

C.

change information for existing Destination Point/mailbox with TG_______________
(Read instructions on page 7 carefully.)

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

3. Indicate your type of organization.
Postsecondary educational institution (school), go to Step Two, Section 1 on page 14
Institutional third-party servicer, go to Step Two, Section 1 on page 14
Guaranty agency for FFELP student loans, go to Step Two, Section 2 on page 18
Guaranty agency servicers for FFELP student loans, go to Step Two, Section 2 on page 18
Title IV Additional Servicers (TIVAS), go to Step Two, Section 2 on page 18
Lender for FFELP student loans, go to Step Two, Section 3 on page 21
Lender servicers for FFELP student loans, go to Step Two, Section 3 on page 21

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________________________
TG number_____________________________
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Expiration Date: 12/31/2013
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Step Two
Section 1: Services for Postsecondary Educational Institutions or Institutional ThirdParty Servicers
5. Do you want this Destination Point (TG Number/Mailbox) to submit and/or receive data with the Central Processing
System (CPS)?

Yes
No, go to Question 6
A. If yes, for which school?
Name of school____________________________________________________________________________
Federal School Code________________________________________________________________________
Check if the address is the same as in Question 4. Go to Question 5-B.
Check if applying for an assigned Federal School Code (for authorized branch campuses only)
If the mailing address is different from Question 4, provide the following address information:
Business address___________________________________________________________________________
City__________________________________________State_______________________Zip______________
B. For which award years? (Check one or both.)
2010-2011-2009
2011-2012
C. Which Destination Point will be transmitting and receiving data for the services selected below?
All of the following to the same Destination Point
TG___________________

Initial applications* (initial FAFSAs)
TG________ TG________
Corrections (FAFSA corrections)
TG___________________
ISIRs
TG___________________
D. If ISIRs are selected, choose delivery option
ISIR Delivery: 2010-2011
Daily
By request
2011-2012
Daily
By request
E. Do you want this Destination Point to only access and administer CPS Online services for the school selected?
Note: Only select this option if your school utilizes a third-party servicer to submit batch services to CPS, and
you want access to CPS Online tools such as FAA Access to CPS Online and Return to Title IV.
Yes (DO NOT select if your school is already enrolled to submit Batch Services for CPS).
If you are adding this service to an existing Destination Point, provide the TG Number: ______________
*Data for initial FAFSA applications may come from two different TG numbers. All other CPS data must be exchanged through a
single Destination Point.

6. Do you want this Destination Point (TG Number/Mailbox) to submit and receive Direct Loan or Federally held
FFELP information?

Yes, for 2010-2011
Yes, for 2011-2012
No, go to question 7
A. If yes, for which school?
Name of school _____________________________________________________________________
 heck if address is same as in Question 4. Go to Question 7.
C
If the mailing address is different from Question 4, provide the following address information:
Business Address _______________________________________________--____________________
Business Address _______________________________________________--____________________
City______________________________________State______________________Zip_____________
If you are adding this service to an existing Destination Point, provide the TG Number: _____________
What is your Direct Loan Code? _________________________________________________________
OMB NO: 1845-0002
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Step Two
Section 1: Services for Postsecondary Educational Institutions or Institutional ThirdParty Servicers (Continued)
7. Do you want this Destination Point (TG Number/Mailbox) to submit and/or receive Grant Services (Pell Grant, Iraq
Afghanistan Service Grant, ACG, National SMART Grant, and TEACH Grant) payment data?
Yes

No, go to Question 8

A. If yes, for which school?
Name of school____________________________________________________________________________
Federal School Code________________________________________________________________________
Check if the address is the same as in Question 4. Go to Question 7-B
If the mailing address is different from Question 4, provide the following address information:
Business address___________________________________________________________________________
Business address___________________________________________________________________________
City_____________________________________State____________________Zip______________________
B. For which award year? (Check when you want services to begin)
2009-2010

2010-2011

2011-2012

C. Which Destination Point will be transmitting and receiving data?
TG _____________
8. Have you participated in or intend to participate in the electronic Campus-Based (eCB) Programs systems (FWS,
FSEOG, Perkins)?
Yes



No, go to Question 9.

If yes, provide the OPE-ID number ________________
Provide the name of the school __________________________________________________________________
Identify the award year(s) that you have participated in or intend to participate in the eCB Programs systems and the
TG number that is responsible for reporting that year.
If you are a new school, ONLY select the 2011-2012 award year and leave the TG number blank
2007-2008 TG_______________


2008-2009 TG _____________

2010-2011 TG ______________

2009-2010 TG _____________

2011-2012 TG ______________

Check this box if the mailing address for eCB Programs systems material is the same as in Question 4.
Go to Question 9.

If your mailing address for eCB is different from Question 4, provide the following address information:
Business address_______________________________________________________________________________
City_________________________________ State_________________________ Zip_______________________
Office Use Only
Customer number________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
December 2010

TG number_____________________________
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Step Two
Section 1: Services for Postsecondary Educational Institutions or Institutional ThirdParty Servicers (Continued)
9. A. Do you want this Destination Point (TG Number/Mailbox) to submit and receive any of the following NSLDS
batch files?
- Transfer Student Monitoring
- Federal Perkins Loan data
- Enrollment Reporting (formerly SSCR)
 es
Y

No, go to Question 10.
If yes, for which school? Name __________________________________________
School OPE-ID _________________________________
Check if the address is the same as in Question 4. Go to Question 9-B.
If the mailing address is different from Question 4, provide the following address information:
Business address____________________________________________________________________________
City____________________________________ State_________________________ Zip_________________
B. If yes, which information? If you are adding this service to an existing Destination Point, provide the TG
Number below for each service you select.
Transfer Student Monitoring
SAIG mailbox TG_______
(School Transfer Profile must be completed at http://www.nslds.ed.gov/nslds_FAP/secure/logon.jsp to begin
Transfer Monitoring.)




Enrollment Reporting (formerly SSCR)
SAIG mailbox TG_______

Effective Date ______/______/_____

Perkins Loan data
SAIG mailbox TG_______

Effective Date ______/______/_____

10. Do you want this Destination Point (TG Number/Mailbox) for receipt of electronic Cohort Default Rate Notification
Package?
Yes

No, go to Question 11.
Name of school_____________________________________________________________________________
School OPE-ID______________________________________________________________________________


Check if the address is the same as in Question 4.
If the mailing address is different from Question 4, provide the following address information:
Business address____________________________________________________________________________
Business address____________________________________________________________________________
City_____________________________________State____________________Zip_______________________
Effective Date __________________________________
Which TG number will be receiving the eCDR Notification Package? TG_________________________________
If the Destination Point is a third-party servicer, provide servicer name: ___________________________________

OMB NO: 1845-0002
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Step Two
Section 1: Services for Postsecondary Educational Institutions or Institutional ThirdParty Servicers (Continued)
11. Do you want this Destination Point Administrator (DPA) to have access to NSLDS Online?
Yes

No, go to Question 12

If you want this DPA to provide online updates to any of the following NSLDS information, indicate below which
NSLDS information you want this DPA to access. (NSLDS will send the DPA a separate ID and password.)
Default Services (automatically given to users)


Enrollment Update
Overpayment Update

If you are adding this service to an existing Destination Point, provide the TG Number: _______________
What is the OPE-ID for which you are requesting access? _________________________

12. Do you want this Destination Point (TG Number/Mailbox) to receive TIVAS or the Direct Loan Borrower
Delinquency Reports?
Yes



No, go to Step Three

If yes, check the appropriate boxes.

Report Format

Data Format

Both

If you are adding this service to an existing Destination Point, provide the TG Number: _______________
What is your Direct Loan Code? _________________________

Go to Step Three

Office Use Only
Customer number________________________
TG number_____________________________
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Step Two
Section 2: Services for FFELP Guaranty Agencies (GAs), Guaranty Agency (GA)
Servicers and TIVAS
13. Do you want this Destination Point (TG Number/Mailbox) to receive data from the Central Processing System
(CPS)? (Not applicable for TIVAS)


Yes

No, go to Question 14

A. If yes, for which agency?
Name of Guaranty Agency__________________________________ State__________________________
Check if the address is the same as in Question 4.
If the mailing address is different from Question 4, provide the following address information:
Business address__________________________________________________________________________
City______________________________________State____________________Zip___________________
B. If yes, select the desired service(s)
Automatic ISIR Processing: Residents
Automatic ISIR Processing: Non-Residents
C. For which award years? (Check one or both.)
2010-2011



2011-2012

D. If ISIRs are selected, choose delivery option:
2010-2011

Daily

By request

2011-2012

Daily

By request

14. Do you want this Destination Point (TG Number/Mailbox) to send and receive files for Borrower Services?
Yes

No, go to Question 15

A. If yes, for which organization?
Name of GA/TIVAS____________________________________ GA Code__________________________
Check if the address is the same as in Question 4.
If the mailing address is different from Question 4, provide the following address information:
Business address__________________________________________________________________________
City______________________________________State____________________Zip___________________
B.

If you are adding this service to an existing Destination Point, provide the TG Number: ________________

Office Use Only
Customer number________________________
TG number_____________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
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Step Two
Section 2: Services for FFELP Guaranty Agencies, Guaranty Agency Servicers and
TIVAS (Continued)
15. Do you want this Destination Point (TG Number/Mailbox) to submit data for Guaranty Agency Financial Reporting
(GAFR)? (Not applicable for TIVAS)
Yes
No, go to Question 16
A. If yes, for which agency?
Name of Guaranty Agency________________________________ GA Code__________________________
Check if the address is the same as in Question 4.
If the mailing address is different from Question 4, provide the following address information:
Business address__________________________________________________________________________
City______________________________________State____________________Zip___________________
B.

If you are adding this service to an existing Destination Point, provide the TG Number: ________________

16. Do you want this Destination Point (TG Number/Mailbox) to submit and receive any of the following NSLDS batch
files?
- GA/TIVAS Loan Data
- GA Loan Processing and Issuance Fee back-up detail
- GA Annual Reasonability back-up detail
- GA Account Maintenance Fee back-up detail
Yes



No, go to Question 17

A. If yes, for which organization?
Name of GA/TIVAS____________________________________ GA Code__________________________
Check if address is same as in Question 4.
If the mailing address is different from Question 4, provide the following address information:
Business address__________________________________________________________________________
City______________________________________State____________________Zip___________________
B. If yes, which information? If you are adding this service to an existing Destination Point, provide the TG
Number below for each service you select.




Batch GA/TIVAS Loan data
SAIG mailbox TG_______

Effective Date ______/______/_____



GA Loan Processing and Issuance Fee (LPIF) back-up detail
SAIG mailbox TG_______
Effective Date ______/______/_____


GA Account Maintenance Fee (AMF) back-up detail
SAIG mailbox TG_______
Effective Date ______/______/_____


GA Annual Reasonability back-up detail, quarterly and annual calculations
SAIG mailbox TG_______
Effective Date ______/______/_____

Office Use Only
Customer number________________________
December 2010

TG number_____________________________
Postsecondary Institution/FFELP Guaranty Agency/TIVAS/FFELP Lender Form

Page 19

Step Two
Section 2: Services for FFELP Guaranty Agencies and Guaranty Agency Servicers
(Continued)
17. Do you want this Destination Point Administrator (DPA) to have access to NSLDS Online?
Yes

No, go to Step Three

A. If you want this DPA to provide online updates to any of the following NSLDS information, indicate below
which NSLDS information you want this DPA to access. (NSLDS will send the DPA a separate ID and
password.)
Default Services (automatically given to users)
GA/TIVAS Online Loan Update and Teacher Loan Forgiveness/Loan Discharge
Teacher Loan Forgiveness and Loan Discharge Update onlyDischarge Update
If you are adding this service to an existing Destination Point, provide the TG Number: _______________
What is the GA Code for which you are requesting access? _________________________
B.

Indicate your job functions: (check all that apply):
GA, GA Servicer or TIVAS
Uses NSLDS for Title IV functions only
Eligibility for Aid
Billing and Collection
Enforcing Loan Terms
Enrollment
Accuracy of Record
Default Aversion
Default Rates
Record Updates
Teacher Loan Forgiveness and Loan Discharge
Compliance
Other ________________________________________________________________

Go to Step Three

Office Use Only
Customer number________________________
TG number_____________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
December 2010

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Step Two
Section 3: Services for FFELP Lenders and Lender Servicers
18. Do you want this Destination Point (TG Number/Mailbox) to send/receive data from the quarterly Lender Reporting
System (LaRS)?
Yes

No, go to Question 19

A. If yes, for which lender/servicer?
Name of lender/servicer______________________________________________________________________
Lender/Servicer Code_____________________________________________________________________
Check if address is same as in Question 4.
If the mailing address is different from Question 4, provide the following address information:
Business address___________________________________________________________________________
Business address___________________________________________________________________________
City_____________________________________State____________________Zip______________________
B. Which Destination Point (TG Number/Mailbox) will be submitting the data?
TG _____________________________
19. Do you want this Destination Point Administrator (DPA) to have access to NSLDS Online?
Yes

No, go to Step Three

A. If you want this DPA to provide online updates to any of the following NSLDS information, indicate below
which NSLDS information you want this DPA to access. (NSLDS will send the DPA a separate ID and
password.)
Default Services (automatically given to users)
If you are a FFEL Program lender, what is your lender ID number? _______________________________
B. Indicate your job functions: (check all that apply):
Lender and Lender/Servicer
Uses NSLDS for Title IV functions only
Consolidating Lender
Authorized Activity Loan Holder
Enrollment
Accuracy
Deferments
Default Rate
Income Based Repayment
Other ________________________________________________________________

Go to Step Three

Office Use Only
Customer number________________________

OMB NO: 1845-0002
Expiration Date: 12/31/2013
December 2010

TG number_____________________________
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Step Three: 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.

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 has applied for
admission to the institution, the applicant has included the institution on the FAFSA, the lender holds a loan for the
borrower, or the applicant applied for a loan with the lender) before accessing Federal Student Aid systems.
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 13 and referenced in Question 11, page 17; Question 17, page 20; and
Question 19, page 21 is permitted to use the National Student Loan Data System (NSLDS).
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.
Must ensure that password sharing, the sharing of system access, and the use of any tools that allow access to FSA
systems 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 organizations 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).

2.

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

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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.
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 inactivate or delete user access rights for organization employees who no longer require access.
3.

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, 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, TIVAS, 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 January 28, 2005 (70 Fed. Reg.
4112-4115) http://edocket.access.gpo.gov/2005/05-1651.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) TIVAS; and
(h) AIMS.

OMB NO: 1845-0002
Expiration Date: 12/31/2013
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(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.
(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 71 when relevant and
necessary to their duties of exclusive representation.

OMB NO: 1845-0002
Expiration Date: 12/31/2013
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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.
Without the information provided on the SAIG enrollment form, a Participating entity would be denied access to
electronically transmit reports and data via the Student Aid Internet Gateway and would be denied access to all websites
affiliated with their agreement as appropriate.
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 Four

Office Use Only
Customer number________________________
TG number_____________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
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Step Four: Certification of the President/CEO/Chancellor, Equivalent Person, or Designee
1.

Designation of Authorizing Official
You hereby designate _____________________________ - Title ________________, to be your responsible authorizing
official for all future Federal Student Aid System Enrollment forms. All related responsibilities of the
President/CEO/Chancellor, or equivalent person, shall be carried out by this designee. You agree to assume the responsibility
for such actions associated with this and future enrollment agreements. This designation is effective as of the date signed
below. If you as the President, CEO, or Chancellor wish to designate someone other than yourself to sign SAIG Enrollment
forms, you may do so by completing and signing Box 1, and having the person you have appointed to be the designee
complete and sign Box 2.
Box 1

School President/CEO/Chancellor, or equivalent person________________________________________________________
(printed name of President/CEO/Chancellor or equivalent person)

Title __________________________________________________
(printed title)

Signature ______________________________________________ Date _________________________________________
(original signature must be submitted)

2.

Responsibilities of the President/CEO/Chancellor, or Equivalent Person or Designee.
As the President/CEO/Chancellor, equivalent person, or designee, you further certify that:
The name of each individual who is a DPA is included in this application (or is already on file with SAIG).
The organization will immediately update SAIG when there is a change in the designated authorized official or the
Primary or Non-Primary DPA.
Each DPA for your school, agency, or organization has read and understood the responsibilities set out in Step Three
(Responsibilities of the Primary and Non-Primary DPAs), has signed a copy and has kept a copy (of Step Three) for his
or her own records, and submitted a copy with their original signature to the U.S. Department of Education.
That you will ensure that all of the requirements for Primary and Non-Primary DPAs, as provided in Step 3 of this
document, and for Authorizing Officials and DPAs, as provided in Steps 3 and 4, are complied with.
Box 2

Authorized Official__________________________________ Title _____________________________________________
(printed name of Authorized Official)

(printed title)

Signature __________________________________________ Date _____________________________________________
(original signature must be submitted)

Name of School or Agency __________________________________________________________________

If you are a third-party servicer, acting on behalf of another organization, you must read and sign this
certification.
Box 3

Authorized Official__________________________________ Title _____________________________________________
(printed name of Authorized Official)

(printed title)

Signature _______________________________________________ Date ________________________________________
(original signature must be submitted)

Name of Third-Party Servicer_____________________________________________________________________________

Department of Education Authorizing Signature:
Signature _____________________________________________________________

Sign and send this form as instructed.
Office Use Only
Customer number________________________
OMB NO: 1845-0002
Expiration Date: 12/31/2013
December 2010

TG number_____________________________
Page 26
Postsecondary Institution/FFELP Guaranty Agency/TIVAS/FFELP Lender Form

Attachment A: Glossary
Academic Competitiveness Grant (ACG). The Higher Education Reconciliation Act of 2005 (the HERA), Pub. L. 109171, created the Academic Competitiveness Grant (ACG) Program, a new grant program for full-time students at
degree-granting institutions who are Federal Pell Grant recipients, are U.S. citizens, and who have successfully
completed a rigorous secondary school program of study.
Account Maintenance Fee (AMF). AMF is the annual amount of money paid based on a percentage of the original
principal balance of guaranteed loans outstanding during a fiscal year. The AMF back-up detail provides the loan
information used in the calculation.
Annual Reasonability. NSLDS Annual Reasonability is designed to compare the loan-level detail reported to NSLDS and
the aggregated loan data reported on the Guaranty Agency Financial Report (GAFR). In order to accurately
account for the loan-level detail on NSLDS, NSLDS performs two types of calculations on the NSLDS database:
Quarterly Calculations and Yearly Calculations.
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.
electronic Campus-Based (eCB) Programs systems. The Federal Perkins Loan, Federal Work-Study (FWS), and Federal
Supplemental Educational Opportunity Grant (FSEOG) programs are collectively referred to as the eCB Programs
systems because the funds for these programs are awarded directly to the school for awarding and administration.
Central Processing System (CPS). ED’s application data processing facility. The CPS uses information from the Free
Application for Federal Student Aid (FAFSA) to calculate the student’s official Expected Family Contribution
(EFC), to create and transmit to schools the Institutional Student Information Record (ISIR), and to print and mail
to the student the Student Aid Report (SAR).
Cohort Default Rate (eCDR). A measure of the percentage of a school's student borrowers who have defaulted on their
federal student loans.
Common Origination and Disbursement (COD) System. Common Origination and Disbursement (COD) is a streamlined
method for processing Federal Grant Services (Pell, Iraq Afghanistan Service Grant, ACG, SMART, and
TEACH), and Federal Direct Loan data.
Conditional Disability Discharge (CDD). The Conditional Disability Discharge (CDD) Program was created to support
the regulatory requirement to track borrower claims for total and permanent disability discharge for three years.
The regulations require monitoring of income and loan status for a period of three years after certification of
disability by a physician. Borrowers determined to be ineligible after the three-year period will be returned to
active servicing status. However, if the borrower still meets the eligibility criteria at the end of this period, final
discharge of student loan is granted.
Debt Management Collection System (DMCS). The Debt Management Collection System (DMCS) houses all default debt
held by the Department of Education. This includes Federal Family Education Loan Program (FFELP) loans
assigned from Guaranty Agencies (GA), Program Overpayments, Perkins loans assigned from schools, and all the
Direct Loan (DL) program defaults. The system allows ED to place accounts with Private Collections Agencies
(PCA) who do the actual collection activities. The system tracks all debts, interest accruals, and payments at the
loan level and can associate all loans to a specific borrower. The system also interfaces with other government
agencies such as Treasury for the Treasury Offset Program (TOP), Health and Human Services for access to
CAIVERS and the National Database of New Hires (NDNH). The system also sends out bills and
correspondence as needed.

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Destination Point. An electronic mailbox that sends and receives financial aid data using the SAIG. Every Destination
Point is administered by a Primary or a 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 student financial aid programs (such as a postsecondary institution, FFELP lender, FFELP guaranty agency or
third-party servicer) that is enrolled in the SAIG and assigned a Destination Point (TG Number/Mailbox). 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. Note: 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.
EDExpress. A software product provided by ED that allows institutions to enter, edit and manage origination and
disbursement records to report Title IV student financial aid application, grant, and Direct Loan data, using
EDconnect to transmit data over SAIG. This software also has functions that institutions can use to package
financial aid awards.
Enrollment Reporting (formerly SSCR). Report completed by schools or their servicers and used in the administration of
the Federal Family Education Loan Program (FFELP) and the Direct Loan Program to track the enrollment status
of borrowers.
FAA Access to CPS Online. A Web tool that financial aid administrators use to enter application data, view student
information, and make corrections to students’ processed information. It is located at https://faaaccess.ed.gov. An
FSA User ID is required to access student information.
Federal Direct Loan (Direct Loan) Program. A federal program in which the U.S. government (not a commercial lender)
provides four types of education loans to student and parent borrowers directly through schools: Federal Direct
Subsidized Loan, Federal Direct Unsubsidized Loan, Federal Direct PLUS Loan, and the Federal Direct
Consolidation Loan. These loans are referred to collectively as Direct Loans. (The same types of loans are
available through FFELP, but in that program, commercial lenders provide the funds to eligible students.)
Federal Family Education Loan Program (FFELP). A federal loan program under which commercial lenders provide
education loans to student and parent borrowers. The program offers four types of loans: Federal Subsidized
Stafford Loan, Federal Unsubsidized Stafford Loan, Federal PLUS Loan and the Federal Consolidation Loan. All
of these are long-term loans insured by state or private nonprofit guaranty agencies that are reimbursed by the
federal government for all or part of any insurance claims paid to lenders. This guarantee replaces the collateral or
security usually required with long-term consumer loans. (The same types of loans are available through the
Federal Direct Loan Program, but in that program, the U.S government provides the funds directly through
schools.)
Federal Pell Grant (Pell Grant) Program. A federal grant program for undergraduate students with financial need.
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, Iraq Afghanistan Service Grant, ACG, SMART and TEACH),
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.

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Financial Management System (FMS) Federal Student Aid's Financial Management System (FMS) is a centralized system
for all FSA financial transactions. It allows FP users to: collect, process, maintain, transmit, and report data about
financial events ON-LINE. It also provides functionality to support financial planning and budgeting activities,
accumulate and report cost information, and the preparation of financial statements.
Free Application for Federal Student Aid (FAFSA). The application that the student must file to apply for aid from any
Title IV program, including the FFELP and Direct Loan programs. Students can apply online by using FAFSA on
the Web (http://www.fafsa.ed.gov). The FAFSA is also printed and distributed free of charge by the U.S.
Department of Education.
Fiscal Operations Report and Application to Participate (FISAP). The annual report institutions file to report on their use
of eCB program funds for the most recently completed award year and to apply for new funds for an upcoming
award year.
Guaranty Agency (GA). An organization authorized by the U.S. Department of Education to administer the federal
guarantee that loans made under the Federal Family Education Loan Program (FFELP) will be repaid.
Guaranty Agency Financial Reporting (GAFR). The GAFR service allows guaranty agencies the option to send financial
reporting information to Federal Student Aid’s Financial Management System (FMS) using their SAIG mailbox.
Guaranty Agency Servicers. A GA Servicer is an outside organization that contracts with a Guaranty Agency to handle
the exchange of Title IV data between the GA and the Department of Education.
Institutional Student Information Record (ISIR). The ISIR is an electronic federal output document produced by the CPS
from FAFSA data. The ISIR is sent to schools designated by the student on the FAFSA.
IRS Skip Trace. The Treasury Address Request (TAR) Program, referred to as the IRS Skip Trace Process, generates
requests to the Internal Revenue Service (IRS) to provide address information on delinquent and defaulted
borrowers. Selected borrower records on the Debt Management Collection System (DMCS) are merged with
similar records received from numerous schools, loan servicers, and guarantors into a skip trace address request
file to be sent to the IRS. The IRS will return an address for the borrowers matched, and these addresses will
either be entered into the DMCS or forwarded to the requesting entity.
Iraq Afghanistan Service Grant. Beginning with the 2011-2012 Award Year, an eligible student whose parent or guardian
died as a result of U.S. military service in Iraq or Afghanistan after September 11, 2001, may receive increased
amounts of Title IV student financial assistance. Such students are eligible for increased aid under these
provisions if the student was 23 years of age or younger when the parent or guardian died or, if the student was
over age 23, he or she was enrolled at an institution of higher education at the time of the parent or guardian’s
death.
ISIR Datamart Request. This is a function of FAA Access to CPS Online that Destination Point Administrators (DPAs)
can use to request ISIRs from the CPS.
FFELP Lender. A Lender is a commercial entity, such as a bank or credit union, which participates in the FFELP
program and provides capital for student loans.
FFELP Lender Servicer. A Lender Servicer is an outside organization that contracts with a Lender manage FFELP loans
for the Lender.
Lender Reporting System (LaRS). The LaRS allows lender institutions or their servicers the option to send/receive
financial reporting information to Federal Student Aid’s Financial Management System (FMS) using their SAIG
mailbox.
Loan Processing and Issuance Fee (LPIF). LPIF is the quarterly amount of money paid based on a percentage of the
disbursement activity of guaranteed loans during a given quarter of a fiscal year. The LPIF back-up detail
provides the loan information used in the calculation.
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Mandatory Assignment Process (MAP). Collects data pertaining to defaulted FFELP loans from Guaranty Agencies. The
data is loaded to the Debt Management Collection System (DMCS) where it is used by other subsystems within
DMCS to collect monies from defaulted borrowers or otherwise resolve their accounts.
National Directory of New Hires (NDNH). NDNH is the Department of Health and Human Services (HHS), Office of
Child Support Enforcements’ database utilized by the Department of Education (ED) through a computer
matching agreement between ED and HHS to obtain address and employment information on defaulted
borrowers. The NDNH database maintains some of the most comprehensive address and employment
information on individuals throughout the United States.
National Science and Mathematics Access to Retain Talent Grant (National SMART Grant). The Higher Education
Reconciliation Act of 2005 (the HERA), Pub. L. 109-171, created the National Science and Mathematics Access
to Retain Talent Grant (National SMART Grant), a grant program for full-time students at degree-granting
institutions who are Pell Grant recipients and are U.S. citizens.
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 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.
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 SAIG Mailboxes and FAA Access Online
users.. 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).
Student Aid Report (SAR). The federal output document produced by the CPS containing information submitted by the
applicant on the FAFSA as well as CPS processing results. It is made available to the student online or mailed by
U.S. postal mail.
Social Security Number (SSN). 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 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 student financial
aid programs and delivery system. Organizations enroll individuals as DPAs in the SAIG. DPAs are assigned
Destination Points (electronic mailboxes) which receive and transmit data for various Title IV student aid
program systems such as NSLDS, CPS, and COD. (See Destination Point and Destination Point Administrator.)
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.
TDClient. ED’s telecommunications software that allows Mainframe/Midrange users to send and receive data through the
SAIG.

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Teacher Education Assistance for College and Higher Education (TEACH) Grant Program. The College Cost Reduction
and Access Act (the CCRAA), Pub.L. 110-84, authorized the Teacher Education Assistance for College and
Higher Education (TEACH) Grant Program for implementation beginning with the 2008-2009 award year. The
TEACH Grant Program provides up to $4,000 a year in grant assistance to a student who agrees to serve for at
least four years as a full-time teacher in a high-need field in a public or private elementary or secondary school
that serves students from low-income families. A TEACH Grant recipient who does not complete the required
teaching within a specified timeframe, or fails to meet certain other requirements of the TEACH Grant Program,
will be required to repay the TEACH Grant as a Direct Unsubsidized Loan under the William D. Ford Federal
Direct Loan (Direct Loan) Program.
Title IV Additional Servicers (TIVAS). An organization authorized by Department of Education to administer Federal
Direct and FFELP Loans.
TG Number. A TG Number is the identifier for an electronic mailbox. It is a five-digit alphanumeric number, preceded
by “TG.”
Transfer Student Monitoring (TSM). A function of the NSLDS that monitors student transfers from one school to another.
Following a student transfer, the new school sends identifying information about the student to NSLDS and will
then receive data updates that will allow the school to disburse and/or deliver aid to the student.
Treasury Offset Process (TOP). The Treasury Offset Process refers defaulted borrower debts to the U.S. Department of
Treasury with the ultimate objective of collecting past due accounts by means of offsets of federal funds due the
borrower, such as tax refunds.
U.S. Department of Education (ED, Department). The federal agency responsible for the administration of federal
education programs including the federal student financial aid programs.

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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 this statement. In addition, the Federal Student Aid User Statement must be completed and signed by the user and 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.
Appropriate Use of Federal Student Aid Systems
Appropriate uses of Federal Student Aid systems by a SAIG user (list is not exhaustive):
•
•
•
•
•
•
•
•
•
•

Must use SAIG computing resources only for official government business.
Must ensure that a substantially established relationship with the applicant is in place (e.g., the applicant has applied for
admission to the institution, the applicant has included the institution on the FAFSA, or the lender holds a loan for the borrower)
before accessing Federal Student Aid systems.
Must know the names of the Primary DPA and/or the Non-Primary DPA 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 or Non-Primary DPA any security incidents, potential threats, or vulnerabilities that
involve SAIG resources.
Must report to the Primary DPA and/or Non-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 information from the SAIG 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 avoid the introduction of any code that might be harmful to the SAIG.

TG#__________
Destination Point Administrator (DPA) Name___________________________________
SAIG User Name ________________________________________________________________________
(Print)
SAIG Job Title _____________________________ SSN_______________
Phone #(____)_______________
SAIG User Signature______________________________________Date_________________________
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
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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

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File Typeapplication/pdf
File TitleMicrosoft Word - PM_2011-2012 School Lender GA Enrollment Form_101910.doc
Authorragesu
File Modified2010-10-20
File Created2010-10-20

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