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Private Education Loan Applicant Self-Certification Form


Effective February 14, 2010, per Section 128(e)(3) of the Truth in Lending Act and Section 487(a)(28) of the Higher Education Act of 1965, as amended, upon an enrolled or admitted student's request (or the request of a parent loan applicant) for a private education loan, a school must make available to the applicant — in written or electronic format —

  • The Private Education Loan Applicant Self-Certification Form, and
  • The information required to complete the form — specifically, the student's cost of attendance, estimated financial assistance, and the difference between the two amounts — to the extent that this information is available to the school at the time of the applicant's request.

The purpose of this form is to inform the applicant that

  • Free or lower-cost federal, state, or school aid may be available in place of, or in addition to, a more costly private education loan;
  • A private education loan may reduce eligibility for free or low-cost federal, state, or school aid; and
  • To apply for federal grants, loans and work-study, a student must submit a Free Application for Federal Student Aid (FAFSA), which is available at www.fafsa.gov, or from the school's financial aid office, or may be requested at 1-800-4-FED-AID.

Applicants are strongly encouraged to discuss all financing options, including the availability of free or lower-cost financial assistance, with their school's financial aid office.

Applicants must provide a complete, signed copy of this self-certification form to their private education loan lender. The private loan lender must collect and maintain the self-certification form, prior to disbursement of a private education loan.


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