Parent Certification for the 2008-2009 PLUS Loan

Student's Name:____________________________________________Soc.Sec.#:_____________

I wish to request a PLUS Loan. The parent who will take out the loan should complete the rest of this form.

Parent Borrower Name:_______________________________________________Soc.Sec.#:____________

Date of Birth: _____________ Drivers License: (State)_______ and License Number ____________

Loan Amount Requested:_______________

Academic Period for the Loan:(check one)_____Fall 2008 and Spring 2009 _______Fall 2008 only_____ Spring 2009 only _______Summer 2009

U.S. Citizenship:(check one)_____ U.S. Citizen or National ____Permanent Resident (If Permanent Resident, please list your alien registration number_______________)

Permanent Address:

Parent Borrower Signature:_________________________________________Date:_________________