Application for Michigan Rural Rehabilitation CorporationTuition Assistance for Rural and Farm

Families (TARFF )18625 Centennial Rd, Ste B • PO Box 188 • Marshall, MI 49068-0188

Local Phone: (269) 781-4646 or Toll-free (800) 835-0650FAX: (269) 781-9850 email: mrrc@mrrccollegeloans.com

Section 1 — Applicant Information Please print neatly or type. Read the instructions carefully and complete pages 1 through 4.1. Last Name Date of Birth

(Month/Day/Year)

if used for mailing address Home Cell Message

How long at this address?

( )

4A.City State Zip Code +4 County 6. Driver's License Number (must submit copy with application)

2.

Permanent Address

City, State, Zip Code

Area code/Phone Number ) () (Relationship to Applicant

Yes No

Applicant's Employer Address Monthly Income Full

Telephone Number How Long?

Part $( )

Name/Address of Creditor Account # Balance Due Monthly Payment

$ $

$ $

$ $

11. L

OA

N

you qualify for any other aid

may

yes no $

I have read and understand the above notice regarding other loans, grants and/or scholarships.

LOAN AMOUNTREQUESTED

initial here

$ yes no $ yes no $

Credit Release and Application Verif icat ion

12.Applicant'sSignature

Today's Date(Month/Day/Year)

MT-101 © MRRC 9/15/11

I hereby, authorize MICHIGAN RURAL REHABILITATION CORPORATION to verify my employment earnings records, bank accounts, stock holdings and any other asset balances that are needed to process my educational loan application. I further authorize MICHIGAN RURAL REHABILITATION CORPORATION to order a consumer credit report and verify other credit information including past and/or present indebtedness. It is understood that a photocopy of this form will also serve as authorization. The information is for the confidential use of the lender in determining my creditworthiness for an educational loan. I certify that the above information is true and correct and that I have read and understand the Borrower's Rights and Responsibilities on page 3.

Do you have other loans forthis academic period?

Do you qualify for any grantsor scholarships?

If so, what is the amount?

If so, what isthe amount?

IMPORTANT: Before you apply for this alternative loan (TARFF) you should check with your school financial aid office to see if you qualify for any other aid including Federal Title IV loans, scholarships or grants. Your school may have options available that do not require you to repay the aid and/or other loan options with lower interest rates. Only request or accept the amount you actually need to attend the school of your choice even the maximum loan amount you qualify for may be higher. For more information contact your school or the US Department of Education web site.

Do you qualify for Job Worksor other similar programs?

If so, what isthe amount?

APPLICANTCREDITHISTORY

The following are all loans or debts I owe, including mortgage, credit cards, auto loans, miscellaneous loans, alimony,child support or separate maintenance payments which I am obligated to make. Include any collections or legal action(s).(Attach additional sheet(s) if necessary.)

10.

INCOME9.

8. ELIGIBILITY 8A. Are there any legal action(s) pending against you?

$THIS SECTION MUST BE COMPLETEDBY ALL APPLICANTS

Adjusted Gross TOTALFAMILY Income

8B. I am a United States Citizen? Yes No

8C, D or E,One box must be checked

8C. FarmFamily

There are acres in our family farm, including pasture crop andwoodland. You MUST attach a copy of Schedule F, 1st 2 pages of Federal 1040 form and W-2 form(s).Estimated GROSS Farm Income

8D. Closely associated with agriculture activities. ExampleUSDA or MDA employee; elevator or nursery employee;ag teacher, etc. Attach copy of W-2 form(s) & 1st 2 pages of Federal 1040 form & full explanation.

Resident of small rural Michigan community. Attachcopy of W-2 form(s) & 1st 2 pages of Federal 1040 form & full explanation.

8E.

Have you ever had a loan from MRRC?If yes, is the loan paid in full?

Yes NoYes No

$

7. References: Provide two separate references not living with you or your guarantor with different U.S addresses. The first reference should be a close relative other than your guarantor. Both references must be completed fully. A reference should be someone who will always know how to contact you.

Name

4. Permanent Street Address P.O Box 5. Telephone Number

2. Social Security NumberFirst Name MI

1.

PAGE 1 OF 4

Section 2 — Guarantor Information-REQUIRED Cannot be a spouse Please print neatly or type. Read the instructions carefully and complete pages 1 through 4.

Credit Release and Application Verification

23.Guarantor'sSignature

Today's Date(Month/Day/Year)

Section 3 — SCHOOL AUTHORIZATION - REQUIRED This section must be signed by a school 's financial aid office or administrator.

Yes

No( )

25.

26.

Course of StudyStudent

to EndingDate

Loan Period BeginningDate Expected

Graduation DateStudent ID Part time Full timeGrade Level

COST OF ATTENDANCE

$ FINANCIAL AID AWARDEDTUITION

Is the check required to be copayable to the school and student? Yes No

$ OTHER STUDENT LOANSREQUIRED SCHOOL FEES

Requested Disbursement Dates

TRANSPORTATION

Disb #1 Disb #2 Disb #3

MAXIMUM ALLOWABLEALTERNATIVE LOAN $

ESTIMATED BOOKS REQUIRED SUPPLIESROOM & BOARDMISCELLANEOUS (Please explain)

TOTAL COST OF ATTENDANCE

27. Authorized Signature Type or print name and title Date MT-101 © MRRC 9/15/11

Applicant Last Name Social Security NumberFirst Name MI

13. Last Name 15. Date of Birth (Month/Day/Year)

if used for mailing address Home Cell Message

How long at this address?

( )

16A.City State Zip Code +4 18. Driver's License Number (must submit copy with application)

16. Permanent Street Address P.O Box 17. Telephone Number

14. Social Security NumberFirst Name MI

Guarantor's Employer/Source of Income Address Monthly Income FullTelephone Number How Long?

Part $( )

INCOME20.

19. Relationship to Applicant

Are there any legal action(s) against you? 21A. Yes No I am a United States Citizen? 21B. Yes No

Name/Address of Creditor Account # Balance Due Monthly Payment

$ $

$ $

$ $ you qualify for any other aid

GUARANTORCREDITHISTORY

The following are all loans or debts I owe, including mortgage, credit cards, auto loans, miscellaneous loans, alimony,child support or separate maintenance payments which I am obligated to make. Include any collections or legal action(s).(Attach additional sheet(s) if necessary.)

22.

I hereby, authorize MICHIGAN RURAL REHABILITATION CORPORATION to verify my employment earnings records, bank accounts, stock holdings and any other asset balances that are needed to process this educational loan application. I further authorize MICHIGAN RURAL REHABILITATION CORPORATION to order a consumer credit report and verify other credit information including past and/or present indebtedness. It is understood that a photocopy of this form will also serve as authorization. The information is for the confidential use of the lender in determining my creditworthiness as guarantor for an educational loan.

I certify that the above information is true and correct and that I have read and understand the Guarantor's Rights and Responsibilities on page 4.

Note to schools: The TARFF loan amount may not exceed $8,000 per academic year. Although the loan may be used to cover any legitimate school expensesincluding housing and transportation, the maximum TARFF loan amount will be based only on the amount of tuition, required school fees, estimated book and required supplies.

University, College or Trade School Name24. Federal Code (if applicable) Telephone Number Is the school a participant in any Federal Title IV programs?

Branch Address Fax Number( )

City State Zip Code +4 Email

ACADEMIC INFORMATION

$$

$

$$$

$

$

PAGE 2 OF 4

I certify that the above named student is enrolled in good standing or accepted for enrollment for the academic loan period listed and that the information given in Section 3 is complete and correct to the best of my knowledge.

Borrower’s Rights and Responsibilities Questions?  Contact:  MRRC: (269) 781‐4646 or  1‐800‐835‐0650  1.  Maximum Loan Amounts ‐ I may borrow an amount not to exceed the actual cost of tuition, estimated cost of books, required school fees, and/or cost of required equipment up to the annual and/or cumulative maximum amount for my grade level. 2.  Loan Proceeds ‐ I may use the loan money for any school‐related costs not being met by other loans, grants or savings to allow me to attend the school named for the loan period shown on the Application. The loan money will be disbursed in a pro‐rated amount based on the academic terms at the school unless school costs for one term exceed the amount requested. All loan checks will be co‐payable to me and the Guarantor (Cosigner). When applicable, the check will also be co‐payable to the school. If this loan is disbursed electronically, I will be required to sign an authorization form. 3.  Lender Responsibility – I understand that Michigan Rural Rehabilitation Corporation, hereinafter called the Lender, does not vouch for and is not responsible for the quality of any school or its programs. 4.  Change of Status ‐ I will notify my Lender in writing, if any of the following events occur before my loan is repaid: 

I change my address and/or phone number(s); 

I change my name (for example, maiden name to married name); 

I fail to enroll for the loan period or at the school as listed on my application; 

I withdraw from school; 

I graduate;  I change my employer or my employer’s 

address changes;  

I have any other change in status that would affect my loan status (for example, unemployment, serious illness, etc.); or 

*My Guarantor (Cosigner) has any change of name, address and/or phone number or dies before this debt is paid in full. 5. Interest ‐ The interest rate will be 8% per annum. I may qualify for a Prompt Pay Bonus if I meet one of the conditions listed below based on my Promissory Note or Revised Repayment Disclosure terms. A. 2% reduction (new interest rate: 6% per annum) for the last portion of my repayment term.  To be eligible: I must: 1) Make all payments on time or within a fifteen‐day grace period during the first thirty‐six (36) months of my scheduled repayment term;  2) Make certain payments reach MRRC before the 15th day following due date. 3) Any late fee assessed will make me ineligible to receive this 2% reduction. 4) I understand if I make three late payments in any six‐month period after rate reduction becomes effective, my interest rate will revert to 8%.  However, I may still be eligible for a rate reduction as listed in “B” below.   OR B. 1% reduction (new interest rate: 7% per annum) for the last portion of my repayment term.  To be eligible: I must: 1) Fail to meet criteria for 2% reduction as described above.  (If I previously qualified for a 2% reduction, I may still be eligible for a 1% reduction if I meet the following criteria.); 

2) Make thirty‐six (36) consecutive payments within 15 days of my monthly scheduled due date; or for one‐half on my remaining repayment term, if less than thirty‐six (36) months remain in my repayment term. 3) Any late fee assessed will make me ineligible to receive this 1% reduction until I meet the requirement of consecutive prompt payments for thirty‐six (36) months or one‐half of remaining repayment term. 4) I understand if I make three late payments in any six‐month period after rate reduction becomes effective, my interest rate will revert to 8%, until I again meet the criteria for eligibility as stated above.      OR C. If I repay the entire loan balance in full prior to the end of the original scheduled repayment term; or if I repay the entire loan prior to the end of a Revised Repayment Disclosure, MRRC may waive any interest due on the loan balance at the time of my final payment, if my account is not in arrears.  It is my responsibility to pay all interest on the unpaid amount of the loan from the date of disbursement until the entire principal sum and accrued interest are paid in full.  I am responsible for payment of all interest that accrues on this loan. 6. Cost of Deferring Interest Payments ‐ While In School ‐ I will be required to make monthly interest payments while I am in school.  The in‐school period will be considered a “forbearance” period.  If I do not pay this interest monthly, my Lender may capitalize the interest and add the amount to my principal balance without my written consent.  Capitalization may occur no more frequently than quarterly, except unpaid interest may be accrued at a second or subsequent disbursement.  In addition, I may request forbearance to reduce monthly payments and/or capitalize interest during financial hardship.  MRRC retains the right to limit or deny my request for forbearance. If interest is capitalized, I understand the principal amount of my loan and the total amount of interest I incur will increase.  At my Lender’s option, my loan can be declared in default if I fail to make a scheduled interest (forbearance) payment. A chart is available that allows me to estimate the cost of capitalization and estimate the effect it will have on my monthly payments. 7.  Consequences of Default ‐ If I fail to make payments as agreed, I will be in default.  If I default, the entire unpaid balance, interest, and collection fees will become immediately due and payable.  Failure to repay this loan may result in any or all of the following:  referral to a collection agent, legal action, assessment of collection charges including attorney fees, administrative wage garnishment and negative credit reports. 8.  Credit Bureau Notification ‐ The amount, disbursement, and repayment of my loan will be reported to one or more national credit bureau organizations.   If I default on this loan, this will also be reported to national credit bureaus.  I will be notified at least 30 days in advance of default action. Unless I enter into satisfactory repayment arrangements on the loan within 30 days of the date on the notice, the information will be reported.     My Lender must provide a timely response to a request from any credit organization regarding objections I might raise with that organization about the accuracy and completeness of information. 

9. Repayment Arrangements ‐ I must sign a Promissory Note prior to disbursement.  If applicable, I will receive a Revised Repayment Disclosure within six months of my graduation or last date in school that allows the loan to be repaid within a 10‐year initial maximum repayment term.  Minimum monthly payments must be $25.00 and may shorten the repayment term.  If I have more than one outstanding TARFF loan, my monthly payments may be combined into one payment meeting the 10‐year and/or $25.00 requirements.  If I experience economic hardship, unemployment, or return to school; or if I am unable to meet the terms of my repayment schedule, I will immediately contact my Lender to request forbearance and/or renegotiate my repayment arrangement.  If I make a payment more than 15 days past the scheduled due date, my Lender will assess and collect a 5% or a $5.00 late fee, whichever is less.  If I prepay a payment more than 10 days prior to a scheduled due date, my Lender will apply the entire payment to principal and will accrue interest on the new principal balance on the day prior to my scheduled due date. 10. Cancellation of this Loan ‐ If I should die before this loan is repaid, my Guarantor (Cosigner) and/or my estate will be held responsible for any outstanding indebtedness.  Documentation verifying the death must be submitted to the holder of this Note. If my Guarantor (Cosigner) should die before this loan is repaid, I will notify the Lender with written verification within 60 days. I understand that repayment of this loan is not contingent upon my performance at the school of attendance, nor my ability to obtain employment in my field of study. 11. Forbearance ‐ If I am unable to make my scheduled payments, the Holder of my Promissory Note may allow me to reduce the amount of my payment(s) or to temporarily stop making payment(s) as long as I intend to repay my loan.  This action is called forbearance.  During a period of forbearance, interest charges continue to accrue while I am temporarily permitted to delay or reduce payment(s).  If I am willing but financially unable to make payment(s) under my repayment schedule, I may request forbearance to allow any of the following: 

a short period when I make no payment(s): (Capitalization) 

an extension of time for making payment(s), or 

a period when I make smaller payments than were originally scheduled. 

My Lender is not required to grant forbearance and may require me to provide my reasons for the request and may request additional information.  I may contact my Lender by calling: Local: 269‐781‐4646 or Toll Free 1‐800‐835‐0650. 12.   Questions ‐ I understand I may contact the Lender at any time to discuss the status of this loan.  In order to receive information, I must provide proper identification, if requested.    I certify that I have read and understand the Borrower's Rights and Responsibilities 

_________________________________________ Printed Name  _________________________________________ Signature:  ________________________ Date: PAGE 3‐4           TL S&R ‐102SR © MRRC 9/16/2011 

Guarantor’s (Cosigner) Rights and Responsibilities   

Questions?  Contact:  MRRC: (269) 781‐4646 or  1‐800‐835‐0650                                       1. Guarantor (Cosigner) Acknowledgment  I understand: 

I am being asked to guarantee this debt. 

If the Borrower does not pay the debt, I will be responsible for the repayment of this debt in full, including all principal and interest due to Michigan Rural Rehabilitation Corporation, hereinafter called the Lender, plus any late fees and/or collection costs which increase the loan balance.  

I have examined my own financial status, and I am willing to accept this responsibility. 

If I voluntarily assume responsibility for payment of this debt, or if the Lender requires me to assume responsibility for repayment of this debt, the Borrower’s Rights and Responsibilities above become effective for me, including Prompt Pay Interest Bonus options and forbearance.  In addition, the Lender may renegotiate a repayment agreement if I am unable to meet the terms of the original repayment agreement made with the Borrower. 

2. Repayment            I understand: 

The Lender can collect this debt from me without first trying to collect from the Borrower. 

Repayment of this loan is not contingent upon the Borrower’s performance at the school of attendance, or his/her ability to obtain employment in his/her field of study. 

3. Lender Responsibilities – The Lender must provide me with an exact copy of any Application(s), Promissory Notes(s), revised Repayment Disclosure(s), Forbearance Agreements(s), and all delinquent notices within 15 days of any activity on the loan. 4. Promissory Notes 

I will sign a Promissory Note as Guarantor (Cosigner) prior to disbursement.  If applicable, a revised Repayment Disclosure will be provided within six months of when the Borrower graduates or leaves school.  

5. Loan Proceeds   I understand: 

All loan check(s) will be co‐payable to the Borrower and to me.  When applicable, the check will also be co‐payable to the school.  If this loan is disbursed electronically, I will be required to sign an authorization form.  For Title IV schools, I may be required to sign a waiver of signature form. 

My signature on the check, authorization form or waiver of signature form will serve as proof that I agree to repay this loan if the Borrower is unable or unwilling to fulfill his/her obligation for ANY reason including death or disability. 

The proceeds of this loan are to be used for the Borrower’s educational need(s) not being met by other loans, grants, or savings.  

6.  Lender Responsibility – I understand that Michigan Rural Rehabilitation Corporation does not vouch for and is not responsible for the quality of any school or its programs. 7. Change of Status ‐ I will notify the Lender in writing if any of the following events occur before this loan is repaid in full: 

I change my address 

I change my name 

I change my phone number(s) 8. Credit Bureau Notification I understand: 

As Guarantor (Cosigner), the Lender will report information concerning the amount, disbursement, and repayment of this loan to one or more national credit bureau organizations.   

If the Borrower fails to meet the terms of a repayment agreement, my credit may be affected. 

I will be given the same notification as listed in the Borrower’s Rights and Responsibilities above. 

9. Death or Disability of Borrower   I understand and agree that:  

I must notify the Lender if the Borrower should die or become permanently or temporarily disabled before this loan is repaid.   

I must provide verification in the form of a death certificate and/or a doctor’s certification within 60 days of the Borrower’s death or disability.  

If the Borrower dies or becomes disabled I am fully responsible for repaying any remaining balance this loan.   

10.   Questions ‐ I understand I may contact the Lender at any time to discuss the status of this loan.  In order to receive information, I must provide proper identification, if requested.  

I certify that I have read and understand the Guarantor’s/Cosigner’s Rights and Responsibilities 

_________________________________________ Printed Name  _________________________________________ Signature:  ________________________ Date:                                            PAGE 4‐4           TL S&R ‐102SR © MRRC 9/16/2011 

A supplemental student loan program

for residents of rural Michigan communities

MichiganRuralRehabilitationCorporationLocated at: 18625 Centennial Road, Marshall, Michigan

Mailing Address: P.O. Box 188, Marshall, Michigan 49068-0188 Local Phone: (269) 781-4646 • FAX: (269) 781-9850

Toll Free: 1-800-835-0650 web: www.mrrccollegeloans.com

email: mrrc@mrrccollegeloans.com

Marshall

Exit 38/Exit 108

Exit 110 Exit 112

MRRC office -I-94

I-69

Exit 36 Michigan Avenue

Read This Cover Booklet First

This Loan Application Packet contains three

parts. » Cover Booklet » Instructions » Application/Borrower and Guarantor

Rights and Responsibilities

NOTICE: Before applying for this loan you should know: You may qualify for Federal assistance through a program under Title IV of the Higher

Education Act of 1965, in lieu of, or in addition to, a loan from a non-Federal source; In many cases, a Federal student loan may provide you with more beneficial terms and

conditions, including a lower annual percentage rate and fewer and lower fees, than private educational loans;

You may obtain additional information concerning such Federal financial assistance from your institution of higher education or at the website of the Department of Education;

Your school may have other school-specific educational loans or grants available with more beneficial terms than those disclosed for this loan.

Partello Road

Loan Limits: Annual Cumulative Undergraduate $8,000 $25,000 Graduate $8,000 $37,500*

*Includes undergraduate loans

Tuition Assistance for

Rural and Farm Families

INTRODUCTION

The Tuition Assistance for Rural and Farm Families (TARFF) loan program was developed in July 1997, to assist students from Michigan rural and farm families with educational expenses for college and trade schools. Although there are several federal student loan programs available for students in traditional colleges and universities, the loan limits for those programs do not always meet the financial needs of the student. MRRC also recognizes the fact that there are many students attending school part-time who do not qualify for any aid due to low credit hours, nonparticipating schools, or ineligible programs; and many students attending trade schools with limited access to financial assistance. The TARFF loan program is an educational loan designed to help pay for the cost of higher education for the full-time or part-time student and may be used as a supplement to other student loans and grants, or in place of existing loan programs already available to the student. The applicant is not required to provide any collateral for the loan. However, a creditworthy guarantor (cosigner) IS required for each applicant, regardless of age. (Note: A spouse is not allowed as a guarantor. Age restrictions may apply to minors.) Eligible schools include two-year colleges, four-year colleges and universities, trade schools, certification programs, etc. There are no restrictions for Federal Direct schools or schools not eligible through the Federal Stafford Loan Program. The loan amount is based on actual tuition costs, plus the cost of registration and lab fees, books and required course supplies. Housing, travel and meal expenses are not eligible in determining the loan amount. However, although the amount of the loan is based on tuition related expenses, a TARFF loan may be used for any school-related expense not being met by other loans and/or grants or savings. The borrower is responsible for repaying the entire loan amount and all interest that accrues on the loan from the date of disbursement to the date of final payment. If the borrower fails to make scheduled payments, the guarantor will be notified and will be expected to begin making payments until the loan is paid in full. There is no government subsidy. Fixed interest accrues from date of disbursement @ 8% per annum. Payments of interest-only are required during in-school periods. Full monthly payments are set up for a maximum of 10 years with minimum monthly payments of $25.00 and must begin no later than six months following graduation or last date in school. Borrowers may make larger

payments at any time to reduce the length of the loan period and reduce the total interest cost of the loan with no penalty. An electronic payment option is available with no fee to the borrower. Delinquent accounts are reported to a national credit bureau monthly for both the borrower and the guarantor. A “Prompt Pay Bonus” plan is available to lower the interest rate for borrowers meeting certain conditions. Interest costs may be reduced up to 2% based on length of repayment and prompt or early repayment. TARFF loans have flexible terms—both during the period the borrower is in school and during the period when the loan must be repaid. During repayment, a borrower may be entitled to defer principal payments of the loan in certain circumstances through a forbearance agreement, such as during periods of unemployment, economic hardship, or further study. Minimum payments of at least interest are usually required during any forbearance periods. Limitation of funds: The MRRC Board of Directors reserves the right to limit the amount of funds available for TARFF loans on a year-to-year basis. If this limit is imposed, the applications will be accepted on a first-come-first-serve basis. Final determination of eligibility will be at the sole discretion of MRRC. MRRC reserves the right to make regulation changes at any time. Any outstanding TARFF loans will not be affected by any regulation change, however, any new loan(s) obtained after a regulation change will be made using terms in effect at time of disbursement.

Important Eligibility Information

About a TARFF Loan You are eligible to apply for a TARFF loan if:

• Your family adjusted gross income is less than $60,000

AND • You are a U.S. citizen AND have been a Michigan

resident at least six months (Written verification may be required.) AND

• You are a member of a Michigan farm family; OR • You reside in a small rural Michigan community

(approximately 15,000 or less); OR • You are closely associated with agricultural

activities.

Preparing to Apply √ Check out other financial aid first. Contact your school’s financial aid office for information about grants, scholarships, work-study funds, and other forms of assistance that may be available.

A TARFF loan must be repaid. Think carefully about how much you need to borrow. Determine your total school costs that remain after all other aid is secured. Borrow only the amount necessary to meet your remaining educational expenses, and that you can afford to repay on a monthly basis in addition to your other bills. Remember, a TARFF loan will be considered by other lenders when extending credit to you for things such as credit cards, car loans, and home mortgages. If you borrow more than you need, you may overextend your ability to repay your total indebtedness and be ineligible for any new loans. The amount you borrow must be repaid even if you do not finish the program for any reason, you do not graduate, or you are unable to get a job upon leaving or completing the program. MRRC does not endorse any school or training program.

A creditworthy guarantor (cosigner) is required for all applicants. You must provide a creditworthy guarantor (cosigner) in order to obtain this loan. Usually, a parent is an acceptable choice. A spouse is NOT allowed to guarantee (cosign) a loan. The guarantor (cosigner) must be a U.S. citizen. (Written verification may be required.) Note: Having a creditworthy guarantor (cosigner) does not guarantee approval of the loan. MRRC reserves the right to make the final determination for guarantor (cosigner) eligibility and applicant’s creditworthiness.

Have specific questions? For answers to questions about the TARFF loan program, contact MRRC at the number listed on the front of this form. Instructions for Completing the TARFF Loan Application MRRC will secure a credit report for the applicant and guarantor from a national credit bureau before approving this loan. If the credit report indicates a bankruptcy, default, repossession, unresolved litigation, or outstanding judgment, the loan might not be approved. Any outstanding account may not be more than 60 days past due for any scheduled payment. If your loan is denied because of an adverse credit rating, MRRC will contact you and explain the appeal process.

Do not complete this form in pencil. Use a ball point pen or typewriter. You are making several copies, so press firmly on a hard surface. If all copies are not legible, your application will be delayed. Incorrect or incomplete information may cause your application to be delayed or denied.

Section 1 — Applicant Information

Item 1. Enter your last name, then your first name and middle initial.

Item 2. Enter your nine-digit Social Security Number. An application without a Social Security Number will not be processed.

Item 3. Enter the month, day, and year of your birth.

Item 4. Enter your permanent home street address, apartment number, city, state, and zip code+4. If you have a Post Office Box for your mailing address and a street address, you must list both. How long have you lived at that address? Enter the county you live in.

Item 5. Enter the area code and telephone number for the address listed in Item 4. Mark the type of phone (home, cell, message) for this phone number. If you have no telephone, enter N/A.

Item 6. Enter your current valid Michigan driver’s license number. If you do not have a driver’s license, enter N/A. Include a copy of your driver’s license with your application. If you have no driver’s license, provide two other valid copies of identification.

Item 7. Enter two adult references with different United States addresses, that will always know your current address. Do not use your guarantor as a reference. References with addresses outside the U.S. are not acceptable. All requested items must be complete or your application will be delayed. If a reference does not have a telephone enter N/A in the appropriate space.

Item 8. Check all boxes that apply. If you are from a farm family, you must enter the number of acres and estimated gross farm income and attach a copy of Schedule F. You must complete the box showing Adjusted Gross TOTAL FAMILY income and attach copies of all applicable W-2 forms and 1040 forms. If you are a dependent student you must include your own earnings and your parent(s) earnings. If you are married, you MUST include your spouse’s income.

Item 9. Enter all information for your current employer. Enter how long you have been employed by this employer, whether you are full or part-time, and your estimated monthly gross income.

If you are unemployed, provide the last date of employment and proof of any unemployment income you are currently receiving.

Item 10. List all outstanding loans or debts, including mortgage(s), credit card(s), auto loan(s), miscellaneous loan(s), alimony, child support or separate maintenance payments you are obligated to make. Include any collections, judgments or civil suits. Attach additional sheet(s) if necessary.

Item 11. Read the information regarding other loans, grants or

scholarships and initial the line where indicated. Check the box to indicate if you have other loans available to

you. If so, indicate the amount. Check the box to indicate if you have any grants or

scholarships available to you. If so, indicate the amount. Check the box to indicate if you qualify for Job Works or other

similar programs. If so, indicate the amount.

Enter the amount of the loan you are requesting. Maximum allowable loan: per year cumulative Undergraduate $8,000 $25,000 Graduate $8,000 $37,500* * Includes undergraduate loans

Item 12. Read AND SIGN the Borrower’s Rights and Responsibilities on

the reverse side of the application. READ Credit Release and Application Verification carefully.

Sign your legal name, including your first name, middle initial and last name. Use a ball point pen. Enter the date you are signing the application.

By signing, you:

1). Acknowledge that you have read, understand, and agree to the provisions in the Applicant Credit Release and Application Verification section.

2). Acknowledge that you have read, understand, and agree to the provisions in the Borrower’s Rights and Responsibilities section on the reverse side of the application.

3). Acknowledge that you understand this is a loan that will have to be repaid with interest to the lender according to the terms and conditions of a promissory note required to be signed by you and your guarantor before disbursement.

4). Acknowledge that you read and understand that you may be eligible for other loans or grants including Federal Title IV loans with more beneficial interest rates and terms.

NOTE: Applicant signature(s) and date are required. If you fail to sign and date the application, your application will not be processed. Section 2 — Guarantor (Cosigner) Information All applicants must provide a creditworthy, U.S. citizen guarantor. A spouse is NOT acceptable as a guarantor. Item 13. Enter your last name, then your first name and middle initial. Item 14. Enter your nine-digit Social Security Number. An application

without a Social Security Number will not be processed. Item 15. Enter the month, day, and year of your birth.

Item 16. Enter your permanent home street address, apartment number,

city, state, and zip code+4. If you have a Post Office Box for your mailing address and a street address, you must list both. How long have you lived at that address?

Item 17. Enter the area code and telephone number for the address listed

in Item 16. Please indicate if this is a home or cell phone. If you have no telephone, enter N/A.

Item 18. Enter your current driver’s license number, listing the state that issued this license, followed by the number. If you do not have a driver’s license, enter N/A. Include a copy of your driver’s license with the application. If you have no driver’s license, provide two other valid copies of identification.

Item 19. Enter your relationship to the applicant.

Item 20. Enter all information for your current employer. Enter how long you have been employed by this employer, whether you are full or part-time, and your estimated monthly gross income. If you are not employed, you will need to provide written proof of income from social security, retirement plan(s), etc.

NOTE: You may not be eligible to guarantee this loan if your only source of income is exempt from attachment or garnishment by law.

Item 21. A. Are there any legal action(s) pending against you? Check YES or NO.

B. Are you a U.S. citizen? Check YES or NO.

Item 22. List all outstanding loans or debts, including mortgages(s), credit card(s), auto loan(s), miscellaneous loan(s), alimony, child support or separate maintenance payments you are obligated to make. Include any collections, judgments or civil suits. Attach additional sheet(s) if necessary.

Item 23. Read AND SIGN the Guarantor’s Rights and Responsibilities on the reverse side of the application. READ the Credit Release and Application Verification carefully.

Sign your legal name, including your first name, middle initial and last name with a pen. Enter the date you are signing the application.

By signing, you:

1). Acknowledge that you have read, understand, and agree to the provisions in the Guarantor Credit Release and Application Verification section.

2). Acknowledge that you have read, understand, and agree to the provisions in the Guarantor’s Rights and Responsibilities section on the reverse side of the application.

3). Acknowledge that you understand this is a loan that will have to be repaid with interest to the lender according to the terms and conditions of a promissory note required to be signed by you and the applicant before disbursement.

4). Acknowledge that you will be responsible for this indebtedness if the applicant fails to repay the loan as agreed for any reason.

NOTE: Guarantor signature(s) and date are required. If you fail to sign and date the application, this application will not be processed. Section 3 — School Authorization — REQUIRED! To be completed by your school’s financial aid officer. Item 24. Enter all school information, if applicable. Item 25. Enter academic information.

Item 26. Enter cost of attendance, other financial aid, and maximum allowable alternative loan amount. If multiple disbursements are required, list required disbursement dates.

Item 27. Sign and date form.

Send your completed application to:

Michigan Rural Rehabilitation Corporation Post Office Box 188 Marshall, MI 49068-0188

Be sure to include: • Signed, dated application NOTE: Signatures of applicant,

guarantor (cosigner), and school authorization required. • NOTE: For truck driving schools you need to include a

copy of your contract and a copy of your TIP For all other trade schools you need to include a copy of

your contract • Copy of front and back of borrower’s driver’s license OR two

other pieces of identification including one photo ID • Copy of schedule F and/or 1040 and all W-2’s for applicant • Additional sheet(s) if necessary for applicant’s credit history • Copy of front and back of guarantor driver’s license OR two

other pieces of identification including one photo ID • Copy of 1040 and W-2’s or other income verification for

guarantor • Additional sheet(s) if necessary for guarantor’s credit history

If you need assistance, call our office: Local (269) 781-4646 or Toll Free: 1-800-835-0650 Monday - Friday 9:00 AM - 4:00 PM

MT-101C © MRRC 6/2011

NOTICE: As per Federal identity theft regulations that became effective July 1, 2008, you must provide a copy of the FRONT and BACK of the driver’s license for both the applicant and cosigner/guarantor.