Loan Info PDF
Loan Info PDF
Permanent Address (Street Address only-No P.O. Boxes allowed) City State Zip Code
8400 NW 26TH ST SUNRISE FL 33322-2910
Prior Address (if you have been at your permanent address less than one year, please provide prior address) City State/Province Zip Code
US Address
Non-US Address
Current Mailing Address (if this is the same as your permanent address, you can leave this section blank) City State/Province Zip Code
US Address
Non-US Address
Repayment Option School Name School City School State
Interest Only BROWARD COLLEGE FT LAUDERDALE FL
Degree/Certificate of Study Major (Course of Study) Anticipated Graduation/Completion Date Enrollment Status
Associates NUR 12-15-2013 ✘ Full Time Half-Time Less Than Half-Time
Requested Loan Amount Cumulative GPA Scale: Academic Period for the Loan Grade Level (select one)
4.0 5.0 6.0 other From (mm/dd/yyyy) To (mm/dd/yyyy) Undergraduate ✘1 2 3 4 5 R
40,000.00
$________________________________ 08-15-2011 08-15-2012 Graduate A B C D
Employment Status Current Employer Name Occupation Work Phone Number Extension Length of Time at Current Employer
Employed FT WALGREENS PHARMACY Other (954) 748-5000 12 9
Years___________ Months ___________
You do not need to reveal alimony, child support or maintenance income if you do not wish to have it considered as a basis for loan repayment.
Gross Annual Income Gross Annual Additional Income Source of Additional Income Gross Annual Additional Household Income Source of Additional Household Income
30,000.00
$_____________________ $______________________ $_____________________________
Do you have one or more of the accounts listed below? Residence Type Monthly Mortgage/Rent Amount
Checking ✘ Yes No ✘ Own Rent Live with parent(s) Dorm Other 899
Other Savings/Assets Yes ✘ No
Personal Contacts: You must provide two (2) adult references, one of which should be a relative. You may not list the cosigner as a reference.
Last Name First Name Relationship to Student
GOLDSTEIN ADRIENNE PARENT (GUARDIAN)
Address City State Zip Code Primary Phone Number
9281 SUNRISE LAKES B SUNRISE FL 33322 (954) 873-1307
Last Name First Name Relationship to Student
GOLDSTEIN ALLEN PARENT (GUARDIAN)
Address City State Zip Code Primary Phone Number
Employment Status Current Employer Name Occupation Work Phone Number Extension Length of Time at Current Employer
Retired Years___________ Months ___________
You do not need to reveal alimony, child support or maintenance income if you do not wish to have it considered as a basis for loan repayment.
Gross Annual Income Gross Annual Additional Income Source of Additional Income Gross Annual Additional Household Income Source of Additional Household Income
CRISSIE VERDI
Student Signature ___________________________________(seal)
629154F8FBAA3F36952C1C69E1B7C2FE Date______________
04/02/2011 Cosigner Signature______________________________(seal) Date_______________
OLA_RETURN Return
Return Application
Application To:Sallie
To: Sallie Mae
Mae • P.O.
• P.O. Box9435
Box 9435• Wilkes-Barre,
• Wilkes-Barre,PA
PA18773-9435
18773-9435 (Copyright Sallie Mae 2000-2011 )
In this Promissory Note (“Note”) the words “I,” “me,” “my,” “mine” 5. Additional Terms - The terms “Interest,” “Forbearance Fee,”
and “we” mean the borrower and cosigner(s) who signed the “Deferment Fee,” “Late Charge,” “Supplemental Fee,” “Payment
application, unless the language specifically refers to only one or the Return Fee,” and “Collection Costs” are defined in the Note
other. “You,” “your,” and “yours” mean the lender as listed below and sections so titled. “Variable Rate,” “Index,” and “Margin” are
any subsequent holder of this Note. “School” means the school I defined under Section C, Interest, of this Note.
identified in the loan application.
Lender: SALLIE MAE C. INTEREST
1. Accrual of Interest - Interest on this Note will accrue at the Variable
Rate (as defined below), beginning on the first Disbursement Date,
on the principal balance advanced and Capitalized Interest, Fees
MURRAY UT and Other Amounts, until the principal balance and all accrued
A. PROMISE TO PAY; BILLING STATEMENTS interest are paid in full. The Variable Rate will be used to calculate
1. Promise to Pay - I promise to pay to your order according to the interest during the entire term of this Note, and following the
terms below the sum of: the Loan Amount Requested, to the maturity of, or any default under, this Note; there is no initially
extent it is advanced to me, or on my behalf, which includes the discounted, premium or other rate that will be used to calculate
Supplemental Fee at Disbursement (together, identified on the interest under this Note.
Smart Option Student Loan Final Disclosure as the “Total Loan 2. Variable Rate - I will pay interest at a Variable Rate equal to the
Amount”); other interest, fees and charges accrued or capitalized “Index”, rounded up to the nearest one-eighth of one percent
on the Loan Amount as described in this Note; and, in the event of (0.125%), plus or minus the percentage identified on my
default, reasonable attorney’s fees, and collection agency, court Disclosure (the “Margin”). The Variable Rate may change each
and other collection costs, to the extent permitted by law. billing cycle on the Change Date if the Index changes. The Change
2. Billing Statements and Billing Cycles - You may send me a billing Date is the twenty-fifth day of each month, or if the twenty-fifth day
statement for each billing cycle showing the first and last day of of the month is not a New York business day, the next New York
the billing cycle, the amount and payment due date for my next business day. The Index is the one-month London Interbank
monthly payment, and any transactions regarding my loan that Offered Rate (“LIBOR”), which is the average of interbank offered
occurred during the billing cycle. Billing cycles will end on the rates for one-month U.S. dollar-denominated deposits in the
same day each month but due to variations in the number of days London market, as published by Reuters on its Reuters Screen
in a month and an irregular initial billing cycle, the number of days LIBOR01 Page, or any successor page used for the purpose of
in each cycle may vary. Billing cycles will be determined by the displaying that rate. The Index is determined on the most recent
payment due dates shown on the Smart Option Student Loan Final business day that is at least two New York and two London
Disclosure, although the first day of the initial billing cycle will be business days prior to the Change Date. A New York business day
earlier than the date of the first disbursement on the loan. is defined as any day that is not a Saturday, Sunday, holiday or
other day on which banking institutions in New York, New York are
B. DEFINITIONS authorized or ordered by law to close. A London business day is
defined as any day on which commercial banks in London,
1. Capitalized Interest, Fees and Other Amounts - Interest, fees,
England carry on interbank dealings in the London market. For
charges and costs due and not yet paid may be added, without
example, if January 22, 23, and 24 are New York business days,
notice, to the principal amount of the loan, as provided in this
but only January 22 and 23 are London business days, then the
Note. This addition is called “capitalizing.” Since interest accrues
Index for the rate as of January 25 would be determined by the
on the outstanding principal balance, capitalizing increases the
one-month LIBOR on January 22.
total cost of the loan.
3. Substitute Source and Substitute Index - If the Reuters Screen
2. Default - You may declare my loan in default following an event
LIBOR01 Page is unavailable, then the Index will be determined by
described in Section K except as follows: IDAHO, IOWA, KANSAS,
you using another source for the one-month LIBOR, such as
MAINE and SOUTH CAROLINA RESIDENTS ONLY: I will be in
another Reuters service that displays that rate, should one
default if I fail to make a payment as required by this Note (or
continue to do so; any substantially similar service that displays
within 10 days of the time required by this Note, for Iowa
that rate, such as Bloomberg, should it continue to do so; or any
residents) or if the prospect of my payment or performance is
substantially similar source that displays that rate, such as the
significantly impaired (for Iowa residents, if, following an event
Money Rates section of The Wall Street Journal, should it continue
described in Section K, the prospect of my payment is materially
to do so. As an alternative to using another source, you may
impaired). The burden of establishing the prospect of such
decide to calculate the rate using a methodology that is
impairment is on you.
substantially similar to that used to determine the rate when it was
WISCONSIN RESIDENTS ONLY: I will be in default: published by Reuters. If no substitute source is available, or
(a) if I permit to be outstanding an amount exceeding 1 full provides the rate on a timely basis, and if you are unable to
payment which has remained unpaid for more than 10 days calculate the rate, or decide not to do so, then you will choose a
after its scheduled due date or deferred due date, or I fail to pay comparable substitute Index.
the first payment or the last payment within 40 days of its
scheduled due date or deferred due date: or (b) if I fail to D. TERMS OF REPAYMENT
observe any other provision of this Note, the breach of which 1. Repayment Schedule for My Loan - You and I agree that the
materially impairs my ability to pay the amounts due under the repayment schedule for my loan will be established as follows:
Note. prior to the first disbursement you will provide me with a
3. Disbursement Date - The date shown on the loan check or the date Disclosure that sets forth my estimated payments and the
the loan funds are electronically transferred to the School. payment due dates for my loan. The repayment schedule will
4. Disclosure - The Smart Option Student Loan Final Disclosure that assume that the student borrower meets your enrollment
will be sent before the time of my first disbursement and which is requirements while in school and that the student borrower
hereby incorporated into this Note. graduates on time and makes all payments on time.
Spouses of married Wisconsin residents must read the Promissory Note and then sign below to
acknowledge having actual knowledge of the credit being extended under this Note and having waived
the notice requirements of Wisconsin Statute Section 766.56(3)(b).
■ Borrower Married
■ Cosigner Married
________________________________________________________________ _______________________________________________________________
(Name of Wisconsin Borrower) (Social Security Number of Wisconsin Borrower)
________________________________________________________________ _______________________________________________________________
(Name of Wisconsin Cosigner) (Social Security Number of Wisconsin Cosigner)
Cosigner: Please sign, date, and return an original of this notice to:
Sallie Mae • P.O. Box 9435 • Wilkes-Barre, PA 18773-9435