OFFICE OF FINANCIAL AID 


Shuster Hall, Room 136 

250 Bedford Park Blvd., West 
Bronx, Ny 10468 

Phone: 718-960-8545 

Fax: 718-960-8328 

www.lehman.edu/Financial-Aid 

Application for Federal Direct Parent Loan for Undergraduate Students (FPLUS) 2020-21 

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 
https://studentaid.gov/. If you wish to complete a paper MPN, you may print one out at https://studentaid.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# XXX-XX- 

 

(last 4 digits only) Empl ID 

Date of Birth 

/ / 



Address 

City State 

Zip Code 



Student’s Signature 

_ 

Date 




Parent Borrower Information: 


Name SS# Empl ID_ 


Address 

Citizenship Status: 

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


_ 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 inFall/half in Spring) unless otherwise indicated 

Intake Counselor’s Signature: 


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