Student Name: _______________________________________ T# __________________________________
to be
A Federal Direct PLUS Loan is available to the parent of dependent, undergraduate students. A parent may borrow up to the total of the Cost of Attendance minus all
financial aid and other resources received by the student. To apply for a Federal Direct PLUS Loan, the 2019-2020 FAFSA must be filed and the parent borrower
must complete and sign the form below and return to our office.
The Federal Direct PLUS Loan utilizes a Master Promissory Note (MPN). The MPN allows a parent to complete a note that, in most cases, is active for all subsequent
PLUS Loans for up to 10 years. Although the parent should not have to sign a new note for each new loan, the parent still needs to request the specific dollar amount
borrowed and must authorize a credit check. A separate MPN is needed for each student, regardless if the same parent is taking out the loan for each student. If the
parent borrower does not have an active MPN on file, he/she may complete one online at www.studentloans.gov
. NOTE: The parent completing the PLUS Loan
Request Form MUST be the same parent that signs and completes the MPN.
PARENT BORROWER INFORMATION
__________________________________________
Parent Social Security Number
_______________________________ _____________________________ ________________________
Parent Borrower Last Name Parent Borrower First Name Parent Borrower Middle Initial
_________________________________________________________________________________________________
Parent Borrower Address
_______________________________ ______________________________ _________________________
Parent Borrower City Parent Borrower State Parent Borrower Zip
_______________________________ ______________________________ _________________________
Parent Borrower Date of Birth Parent Borrower Home Telephone Number Parent Borrower Cell Phone Number
_______________________________ ______________________________ _________________________
Parent Borrower Driver’s License Number State of Issuance Parent Borrower Email Address
Parent Borrower Citizenship Status: (check one) US Citizen Permanent Resident/Eligible Non-Citizen
A_______________________________________
Alien Registration Number if Non-Citizen
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o Student: (check one) Mother Father Stepmother Stepfather
Instructions: Parent Borrower must complete ALL sections below; print clearly in BLUE or BLACK ink; read and SIGN the Authorizing Statements
* The Higher Education Act of 1965 requires applicants for Federally supported financial aid funds to provide their Social Security Numbers (SSN). As a PLUS applicant, the parent borrower must provide his/her
SSN. The Social Security Number is used to report information to Federal and state agencies. Tennessee Technological University has a strong commitment to ensuring the privacy and confidentiality of student and
family information. Social Security Numbers will not be disclosed without the individual’s consent, except as required by the financial aid program and as allowed by law.
LOAN REQUEST INFORMATION
Term Applying For:
I am requesting a loan in the amount of: $
Refund Authorization: PLUS loan funds are applied to University Charges. If any loan funds remain and create excess aid on my student’s account after ALL
charges have been paid, I authorize the excess aid be given to my STUDENT unless otherwise indicated below:
NO, I do NOT authorize the excess aid to be given to my student. I authorize the excess aid to be sent to the Parent Borrower.
I understand that excess aid not routed to my student will be sent to the Parent Borrower ONLY in the form of a check and mailed to the
address listed above.
Please note that the Accounts Payable Office at Tennessee Technological University can direct deposit excess aid from PLUS loan funds to the
student’s checking account ONLY if “Student” is receiving excess aid. Again, if the box above is not checked, any excess aid will default to the student.
PLEASE CONTI
NUE THIS APPLICA
TION ON THE NEXT PAGE
Mailing Address: Physical Address:
1000 N. Dixie, Box 5076 805 Quadrangle
Cookeville, TN 38505 Jere Whitson Bldg, Rm 301
Ph: 931-372-3073 Fax: 931-372-6309
Office of Financial Aid financialaid@tntech.edu
2019 Fall / 2020 Spring Parent PLUS Loan Request Form
Fall 2019 / Spring 2020
Spring 2020 only
**When determining the amount to request, remember to
allow for the 4.236% Origination Fee for loans
disbursed after Oct. 1, 2019 and before Oct. 1, 2020**
__________________________________________
Student Social Security Number
_______________________________ _____________________________ ________________________
Student Last Name Student First Name Student Middle Initial
_________________________________________________________________________________________________
Student Address
_______________________________ ______________________________ _________________________
Student City Student State Student Zip
_______________________________ ______________________________ _________________________
Student Date of Birth Student Home Telephone Number Student Cell Phone Number
_______________________________ ______________________________ _________________________
Student Driver’s License Number State of Issuance Student Email Address
Student Citizenship Status: (check one) US Citizen Permanent Resident/Eligible Non-Citizen
A______________________________________
Alien Registration Number if Non-Citizen
Instructions: Student or Parent Borrower must complete ALL sections below; print clearly in BLUE or BLACK ink;
* The Higher Education Act of 1965 requires applicants for Federally supported financial aid funds to provide their Social Security Numbers (SSN). As a PLUS applicant, the parent borrower must provide his/her
SSN. The Social Security Number is used to report information to Federal and state agencies. Tennessee Technological University has a strong commitment to ensuring the privacy and confidentiality of student and
family information. Social Security Numbers will not be disclosed without the individual’s consent, except as required by the financial aid program and as allowed by law.
STUDENT INFORMATION
My signature indicates that I am applying for, am eligible to receive, and accept a Federal Direct PLUS
Loan in the amount requested above to be used for the student indicated above.
I authorize the U.S. Department of Education to investigate my credit record and determine my credit
worthiness for this loan.
I certify that any funds received from this loan will be used for expenses related to the above named
student’s attendance at Tennessee Technological University, that the above named student is eligible to
receive the proceeds of this loan, and that the information provided on this form is complete and accurate to
the best of my knowledge.
I understand that the acceptance and processing of this request form does not guarantee credit approval. I
also understand that I must apply for approval of this loan with the U.S. Department of Education by
completing a Federal Direct PLUS Master Promissory Note (MPN).
This Federal Direct PLUS process may take up to 3 weeks for processing. I understand that if these funds
are not available to pay any balance owed the University, the student and/or parent must pay the balance
according to the University Bursar’s deadlines.
Parent Borrower Signature ________________________________ Date: ________________________