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Federal Direct PLUS Loan Application and Master Promissory Note William D. Ford Federal Direct Loan Program
Warning: Any person who knowingly makes a false statement or misrepresentation on this form or any accompanying document is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

OMB No. 1845-0068 Form Approved Exp. Date11/30/2013

SECTION A: BORROWER INFORMATION - TO BE COMPLETED BY ALL BORROWERS; READ THE INSTRUCTIONS IN SECTION G BEFORE COMPLETING THIS SECTION

CHECK ONE - I am a: [ X] Graduate or Professional Student
1. Driver's License State and No. PR 5050969 4. E-mail Address (optional) ramos.nancy09@ymail.com 5. Name and Permanent Address (see instructions) RAMOS , NANCY QUINTAS DE COUNTRY CLUB A18CAROLINA PR 00982 UNITED STATES
8. Employer’s Name and Address

[ ] Parent of a Dependent Undergraduate Student
2. Social Security No. 596344147 6. Area Code/Telephone No. 3. Date of Birth (mm-dd-yyyy) 12/11/1991
7872451558

7. Citizenship Status (to be completed by parent borrowers only -- check one)

(1) [ X ] U.S. Citizen or National (2) [ ] Permanent Resident/Other Eligible Non-Citizen N/AIf (2), Alien Registration No. 9. Work Area Code/Telephone No.

10. References: List two persons with different U.S. addresses who do not live with you and who have known you for at least three years. If you are a parent borrower, do not list the student. 1. 2. madeline rivera hector j ramos Name

Permanent Street Address City, State, Zip Code E-Mail Address (optional) Area Code/Telephone No.Relationship to Borrower

quintas de country club A18 carolina , PR 00982 UNITED STATES

quintas de country club a18 carolina , PR 00982 UNITED STATES

7873173733 MOTHER

7872507417 FATHER

SECTION B: SCHOOL INFORMATION – TO BE COMPLETED BY THE SCHOOL 11. School Name and Address

12. School Code/Branch

13. Identification No.

UNIVERSITY OF PUERTO RICO - RIO PIEDRAS CAMPUS 39PONCE DE LEON AVENUE RÚO PIEDRAS , PR 009313300

G07108

596344147N12G07108999

SECTION C: DEPENDENT UNDERGRADUATE STUDENT INFORMATION – TO BE COMPLETED BY PARENT BORROWERS ONLY 14. Dependent Undergraduate Student's Name (last, first, middle initial) 15. Social Security No.

16. Date of Birth (mm-dd-yyyy)

17.

SECTION D: BORROWER REQUEST, CERTIFICATIONS, AUTHORIZATIONS, AND UNDERSTANDINGS– ALL BORROWERS READ CAREFULLY BEFORE SIGNING BELOW PLUS Loan for a dependent undergraduate student, and if that student has been convicted of, or This is an Application and Master Promissory Note (MPN) for one or more Federal Direct pled nolo contendere or guilty to, a crime involving fraud in obtaining funds under Title IV of the PLUS (Direct PLUS) Loans. I request a Direct PLUS Loan under thisMPN in an amount HEA, the student has completed the repayment of the funds to ED, or to the loan holder in the not to exceed my or (if I am a parent borrower) the student’s annual cost of attendance, case of a Title IV federal student loan. minus other financial aid received for each academic year. For each loan, the school will 19. For each Direct PLUS Loan I receive under this MPN, I make thefollowing authorizations: notify me of the loan amount that I am eligible to borrow. I may cancel a loan or request a A. I authorize the school to certify my eligibility for the loan. lower amount by contacting the school. Additional information about my right to cancel a B. For each loan that I receive under this MPN, I authorize ED to investigate my credit record and loan or request a loweramount is included in the Borrower’s Rights and Responsibilities report information about my loan status to persons and organizations permitted by law to receive Statement and in the disclosure statements that will be provided to me. If I have an adverse that information. credit history and obtain an endorser so that I may receive a Direct PLUS Loan, only one C. I authorize the school to credit my...
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