Northwest State Community College • 22600 State Route 34 • Archbold • OH • 43502
Phone: 419-267-1333 • Fax 419-267-5587 • finaid@northweststate.edu
Name:___________________________ NSCC ID number: N________________
I am requesting an additional: ___ Subsidized Direct Loan
___ Unsubsidized Direct Loan
Total Additional Loan Amount: $_____________ (amount will be split equally between semesters)
Please INITIAL the lines below to acknowledge that you have read and understand the
following statements:
____ According to the National Student Loan Data System (NSLDS) I have borrowed an
aggregate (total combined) amount of $_____________ in federal student loans. All students
borrowing history can be found at https://nslds.ed.gov/.
____ I understand that based on the current interest rate and the total loan debt that I have
accrued, my expected monthly payment will be $___________ (see reverse side) for a period of
10 years according to the standard repayment plan.
____ I understand that I must be attending 6 or more credit hours in order to receive student
loan funds.
____ I understand if my loan is processed for a single semester (i.e. spring only) the loan funds
will be disbursed in two separate payments to my student account. This may have an impact on
the timing and/or the amount of your financial aid refund.
____ I acknowledge the federal student loan funds I receive electronically through the school
are proceeds of a loan, which I must repay, to the lender or the holder according to the terms of
the Master Promissory Note.
____ I understand that my loan may not be forgiven by filing for bankruptcy.
By signing this form, I certify that all the information reported to qualify for federal and state student aid is
complete and correct. WARNING: If you purposely give false or misleading information on this form, you
may be subject to fines and/or other penalties.
Student Signature: ___________________________ Date:___________________
Northwest State Community College does not discriminate on the basis of race, color, national origin, sex, gender identity, disability, religion
or age in its programs or activities.
2020-2021 Supplemental
Loan Request
