Application for Federal Direct Parent Loan for Undergraduate Students (FPLUS) 2019-2020 

Under the Federal Direct Loan Program, your lender is the United States Government. You MUST complete a Master Promissory Note (MPN) before 
your loan can be disbursed. You may complete an electronic Master Promissory Note, using your FSA user id and password, at 
www.studentloans.gov. If you wish to complete a paper MPN, you may print one out at www.studentloans.gov and mail it in. Please be advised 
that that paper process will delay receipt of the loan funds requested. 

If you qualify for a Direct Loan, the excess funds will be disbursed to you in a check mailed to the address you provide on the application, or to your 
child if you so designate below. The Interest rate on the FPLUS loan is currently fixed at 7.60% (subject to change). Repayment of this loan begins 
within 60 days of disbursement. Please refer to https://studentaid.ed.gov/sa/types/loans/plus for more information on FPLUS loans. 

Student Information: 

Name __________________ _ SS# Empl ID__ ____Date of Birth__ __/_ _/_____ 

Address_______________________ _ City State __Zip Code______________ ___ ___ 

Student’s Signature _____________ ___ _______ _ Date__________________________ ___ ____ 

______________________________________ _____ ____________________________________________ __ 

Parent Borrower Information: 

Name _______________________________ SS# Empl ID_ __ ____ _ __ _ 

Address______________________ ________ City State __Zip Code_____________________ 

Please be advised that the student for whom you are 
borrowing must meet all federal loan eligibility 
requirements in order to apply/receive loan funds. 

Requested Loan Amounts: 

Summer $_______ .00 

Fall/Spring $_______ _ .00 

*Loans will be processed for the full academic year (half in 
Fall/half in Spring) unless otherwise indicated 

Intake Counselor’s Signature: _______________________ 


 


Citizenship Status: 

U.S. Citizen: (_) Native (_) Naturalized 

Permanent Resident: Alien Reg. # A__________________ 

*Country of Birth__________________________________ 

Biographical Information: 

D.O.B. ____ /____ /_____ Gender ( ) Male ( ) Female 

Marital Status ( ) Single ( ) Married 

Contact Information: 

Email Address __________________ _________ Home Phone: ( ) ___ ___-___ _____ Cell Phone ( ) ___ -_ _ ____ 

Certifications: 

I am the legal parent or step-parent of the student for whom I am borrowing. 

I request any excess funds from this loan to be disbursed to me ____ OR to my child____. 

I certify that NEITHER I nor my child for whom I am requesting this loan are in default of any Federal Student Loan, nor do we owe 
a repayment of any Federal Title IV grant. I understand that this is a request form. In order to receive funds from this loan I must 
complete and sign a promissory note, either electronically or on paper. My signature below authorizes Lehman College to deduct 
from these loan funds any outstanding balance owed to the college on my child’s behalf. 

____________________________________________ ______________________ 

Signature of Parent Borrower Date