4
· I A istance
f F.
·
l~ersity of Illinois Springfield -:-<?ff1ce o manc1a . ss 206-6724
Un·
On
---
______,
e University Plaza, MS UHB 1015 __ Springfield , llllno1s _62?03-5407 -- Phone. (217)
https://www.uis.edu/financ1ala1d/
2021-2022 Federal Direct Plus Loan Application
· t clearly).
· (Pl
ease prm
PLEASE NOTE: Incomplete or incorrect information will delay processing
1
A. S tudent Name:
2
·
Parent Full Legal Name: _ _ _
4.
5.
Parent Social Security Number:
1
First
3c;; 4 _('R;:
P
arent Home Address: ""3<: :;;~
p
Street
arent Home Phone Number: ( 70x
?
\$.Ir\
- I \4:_\
\?'CaCA
3B. Parent Date of Birth: {)) ( (
Ma t+:e: s,.oc::,
City
I
J
S
)(1 ( l 7 ]
,..
tD44Sr
ZIP
LI !':(ul S
State
) .2..1,t<;.. £:¾5;":'Y
r J..,:36 - 6G""°\ :2 - Sz03, :9
6.
Parent Driver's License Number:
7.
Parent U.S. Citizenship Status (check one):
State of Issuance: _
_il.1:L=--------D Neither
D Permanent Resident or other eligible alien*
~ U.S. Citizen or National
---
J.l. .:\~c~,.cA~e::.,~a:::s:~--__JQ.J..\.(..&t,~of½~\aruui:\~g~-:. . :-_ ____---;M\C1!~--Last
3A.
b67 6 9c; 1 ? (
1B. Student UIN:
~-Y-!!::&..ll..l...l""'1::.UO.... -l,,.=1<~-:;}--!>~~-----
*You must submit an 8 ½ x 11 copy of your alien
registration or green card with the students UIN listed.
Are you (parent borrower) currently in default (default means you have failed to make payments) on a federal education loan or owe a
refund on a federal student grant? Please check one:
~o
□Yes
9. In the event your PLUS loan is denied due to the results of your credit check, I would like to (check one):
8.
~Use an Endorser/Credit-worthy
Co-Signer
□Allow the student to be considered for an additional
Federal Direct Unsubsidized Stafford Loan.**
□Take no further action
**If the student is a freshman or sophomore they are eligible for $6000 and junior and seniors are eligible for $7000.
1o. Please indicate the dollar amount of the PLUS Loan you are requesting: $ \QQQ
(please indicate full year amount).
'I
11. Refund Information: PLUS loan funds are applied to University charges prior to any student aid. If any loan funds remain on
the University student account AFTER all charges have been paid, I authorize the refund to be sent to (check one):
~Student
□Parent
Parent & Student Signature ---- Enter Student "UIN" in Boxes Below
that I am the parent ~fthe stud~nt f~rwhic~ t~e PLUS _loan funds are being requ~sted. By signing this application, I am acceptin 9
1 certify
the PLUS Loan, and I authonze the Urnvers1ty of llhno1s at Springfield to send the above information to the Direct Loan Processing c t
an funds will be credited to my student':n er
to conduct a credit check. If the cre~i~ check is approved, and an active MPN is on fi ,
.
charges.
other
and
fees,
tu1t1on,
of
payment
for
University Account
Student's Signature
IMPORTANT:
1. Upload this form to Enterprise Self-Service Student Requirements under the financial aid tab m k"
every question has been completed and that the appropriate people have signed (above).
'
a mg sure
2. Please be aware that the parent borrower listed above must also have a Master Promissory Note
0
n file. If
you ha~e not already completed one, you may do so at https://studentald.gov.
.
edu/f"in
uis
www
at
website
OFA
the
visit
please
Loan,
PLUS
the
3. If you like to learn more about
anc1alaid
·
·
[ ENTER YOUR 9-DIGIT UIN .. ..
2122
PLUS-E
N
4