HomeMy WebLinkAbout12-7455ROBERT D. KODAK, ESQUIRE
KODAK LAW OFFICES, P.C.
407 N FRONT STREET, PO BOX 11848
HARRISBURG, PA 17108-1848
717 238-7159
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THE HIGHER EDUCATION LOAN
AUTHORITY OF THE STATE OF
MISSOURI aka MOHELA,
Plaintiff
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for Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA nn
NO. a~ ~~/.5 S ltV (~
v
JOSHUA DOMINGUEZ,
Defendant(s)
CIVIL ACTION -LAW
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claim set
forth in the following pages, you must take action within twenty (20) days after this
complaint and notice are served, by entering a written appearance personally or by an
attorney and filing in writing with the court your defenses or objections to the claims set
forth against you. You are warned that if you fail to do so the case may proceed without
you and a judgment may be entered against you by the court without further notice for any
money claimed in the complaint or for any other claim or relief requested by the plaintiff.
You may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW.
THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER.
IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE
TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER
LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LIBERTY AVENUE
CARLISLE PA 17013
717-249-3166 /~
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AVISO
USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las
demandas que se presentan mas adelante en las siguientes paginas, debe tomar action
dentro de los proximos veinte (20) dias despues de la notification de esta Demanda y
Aviso radicando personalmente o por medio de un abogado una comparencencia escrita
y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas
presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar action
como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier
suma de dinero reclamada en la demanda o cualquier otra reclamation o remedio
solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso
adicional. Usted puede perder dinero o propiedad u otros derechos importantes para
usted.
USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO
INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO, LLAME O VAYA A LA
SIGUIENTE OFICINA. ESTA OFICINA PUEDE PROVEERLE INFORMACION A CERCA
DE COMO CONSEGUIR UN ABOGADO.
SI USTED NO PUEDE PAGAR POR LOS SERVICIOS DE UN ABOGADO, ES
POSIBLE QUE ESTA OFICINA LE PUEDA PROVEER INFORMACION SOBRE
AGENCIAS QUE OFREZCAN SERVICIOS LEGALES SIN CARGO O BAJO COSTO A
PERSONAS QUE CUALIFICAN.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LIBERTY AVENUE
CARLISLE PA 17013
717-249-3166
THE HIGHER EDUCATION LOAN ` IN THE COURT OF COMMON PLEAS
AUTHORITY OF THE STATE OF ;CUMBERLAND COUNTY,
MISSOURI aka MOHELA, ~ PENNSYLVANIA
Plaintiff ~/ .I
NO. l 01,- ~ 7S~ C-v
v
JOSHUA DOMINGUEZ, ~ CIVIL ACTION -LAW
Defendant(s)
COMPLAINT
The Plaintiff, THE HIGHER EDUCATION LOAN AUTHORITY OF THE STATE OF
MISSOURI aka MOHELA, by its attorneys, KODAK LAW OFFICES, P.C., brings this
action of Assumpsit against the Defendant(s) to recover the sum of TWENTY ONE
THOUSAND NINE HUNDRED TWO DOLLARS AND TWO CENTS ($21,902.02), along
with interest thereon at the rate of 9.75% from July 17, 2011, together with any and all
court costs incurred by Plaintiff, upon a cause of action of which the following is a
statement:
1. The Plaintiff, THE HIGHER EDUCATION LOAN AUTHORITY OF THE STATE OF
MISSOURI aka MOHELA, is a corporation organized and existing under the laws
of the State of Missouri, having an address of PO BOX 6997, CHESTERFIELD, MO
63006-6997.
2. The Defendant, JOSHUA DOMINGUEZ., is an adult individual residing at 2012
SHEEPFORD ROAD, MECHANCSBURG, CUMBERLAND COUNTY,
PENNSYLVANIA 17055.
F:\USER\Z-MASTER CMP FILES\COMPLAINTS\M\MOHELA 36503 akr.wpd 2
3. On or about August 31, 2006 Defendant(s) submitted a Cash Loan Application and
Promissory Note to Plaintiff, which a loan was granted to Defendant(s), a true and
correct copy of which is attached hereto, marked Exhibit "A" and made a part
hereof.
4. On the dates, in the amounts, and for the prices set forth in a true and correct copy
of the Plaintiff Statement of Account hereto attached, marked Exhibit "B" and
made a part hereof, Plaintiff, at the special instance request of the Defendant(s),
sold and delivered goods, wares and merchandise and/or performed labor and
provided services of the kind and description set forth on said Exhibit to the total
amount of Sixteen Thousand Five Hundred Forty Dollars and Sixty Six Cents
($16, 540.66).
5. The prices charged for said goods, wares and merchandise and/or labor and
services provided were just and reasonable, were the legal and market prices
therefor and were the prices which the Defendant(s) promised and agreed to pay
to Plaintiff.
6. Due to Defendant(s) default in payment of said amount due and owing as aforesaid,
interest has been added to said account in the total amount of One Thousand Four
Hundred Eighty Six Dollars and Two Cents ($1,486.02), as shown on Exhibit "B"
hereto attached.
F:\USER\Z-MASTER CMP FILES\COMPLAINTS\M\MOHELA 38503 akr.wpd 3
7. Due to Defendant(s) default in payment of said amount due and owing as aforesaid,
late fees have been added to said account in the total amount of Two Hundred
Twenty Five Dollars and Zero Cents ($225.00), as shown on Exhibit "B" hereto
attached.
8. The balance due and owing by Defendant(s) to Plaintiff is the sum of Eighteen
Thousand Two Hundred Fifty One Dollars and Sixty Eight Cents ($18,251.68), as
appears by Plaintiff's Statement of Account hereto attached, marked as Exhibit "B"
and made a part hereof.
9. Due to the default of Defendant(s), and pursuant to the terms and conditions of the
Cash Loan Application and Promissory Note executed by Defendant(s) hereto
attached as Exhibit "A", attorney's fees in the total amount of Three Thousand Six
Hundred Fifty Dollars and Thirty Four Cents ($3,650.34) have been added to said
account.
10. Plaintiffs Invoices are not attached to this pleading due to the voluminous nature
of same and have previously been provided to Defendant(s).
11. Plaintiff frequently demanded payment from Defendant(s) of said amount due and
owing as aforesaid, but Defendant(s) refused and neglected and still refuse and
neglect to pay said amount or any part thereof.
F:\USER\Z-MASTER CMP FILES\COMPLAINTS\M\MOHELA 38503 akr.wpd
4
WHEREFORE, Plaintiff brings this suit to recover from Defendant (s) the sum of
TWENTY ONE THOUSAND NINE HUNDRED TWO DOLLARS AND TWO CENTS
($21,902.02), together with interest as set forth herein, together with any and all court costs
incurred by Plaintiff.
Respectfully submitted,
KODAK LAW OFFICES, P.C.
J y .Troutman, Esquire ID#53984
Robert D. Kodak, Esquire ID# 18041
407 North Front Street
Post Office Box #11848
Harrisburg, PA 17108-1848
(717) 238-7159
Attorney for Plaintiff
F:\USER\Z-MASTER CMP FILFS\COMPLAINTS\M\MOFIELA 38503 ala~.wpd
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0 F'[)~$ CASH LOAD APPLICATION AND PROMISSORY NOTE
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PRONIISE TO PAY: $ 1 s' , 0 0 0 ~,;,,~,,,~ or° ~~'~',°;;~~ °` "°°'`~`'°°
lKaeia (haeiaaRor "Nate"), all stoat disMttsed la er or oa toy behalf order the tetstst of this Nat, inteten on ttteh stags, We pttyasntt ehtrcEes and ektck raerta fes s provided in
this Nttk, atd goy a0owsbk ousts you iaau is ot>I~ ihb NtNe, indudinS twomble attottlty kes. 1 UNDERSTAND THAT TIUS IS A NOTE N+IItC11 I Witrl. BE
RF.QU[RED TO PAY.1 WILL NOT SIGN THE APPLICATION BEFORE READING TH18 NOTE EVEN [F OTHEAWiSEADVI~A. THE TE8tM.4 A
CONDITIONS SF.1' F'ORTII iN THIS NOTE, CONSTPIV'I'ETIlE EKfiREAGREEMENT DETWEEN YO17 AND ME. i AM EN77T1ED TO AN EXA~COPY OF
TINS NOTE.INY SH:NATURF. CERTIFIES THAT I I1AV6 READ, UNDERSTAND, AND ACRIiE TO TIIE TERMS OM THISi NOTE. I NAVE THF. R Tp PAY
W AD E THE UNPAfU VALANCE DUB UNDER TRtS NOTE v- RUOUT PENH LTY. The ! er is indicekd in Sdiw 1 of ttds Nde
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R•SaroS 5169104684
.,il!n vnllr namr. 1PVihly sin~1 e:xartly ac it ar-Iwarc in tha annlinati~n
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Page 2 of S
to aeei nn 2 (the "Vuiable Ratc.'~
PROMISSORY NpTF.I )iORROWER'S COPY
(n this Application aad Promissory Nde the words "f ~ "nu", "rnY" srtd °mine" mryn the
Borrtrvrer ard/a the tosigtrm, as the comet indicates. "You", `yovr' and "your" mean the
Origimting Lrnde , nr iu zucresson and assigns, and any other holder of this Nde, inebding
MOFIELA.
I awhortzc the I.erxkr, its servicer, a MOHEL~ m the gttsrantor of this loan, yr the tr~nts of
my of than b investigate my cteditwrxthitxss, to icy Wt and rcteive eredh-related rnforrmtion
shout me from odtas tad m fttrtrSslr infornW ion wrtcerning my lash or application and related
documents to tbtstruner rcporitng sgenciu end odxr persona who may legally receive such
inforntsttott, I authorim my school to reeeive, pmvrde, and trorifttm information rtgurding my
attendance, financial rid, rte ettrolfinent status for catrsideraeion of thin application
trddrng a ttdrttachrtg the percemage per annum ante re my
'll thm turd the rewh of lha addition or
at the Vonable Rare deathbed be w m t
2 Variable Rate • I will pay a Viriable Rate of intrest. The intacst rate I will pay will change
onthe first day ofJaauary, April, July and October if the Curren Irtdrx (dcfirxd 6etow) changes.
Felt dote an which my iroerctt tau rnutd change is rolled o "Change Dxe." The initial
inttuaq me shall be rm steed in my initial d'tsclrmurc staterttere (the "Disclocurc Stuernent"}
whielt is hereby irrcorporated itrto this Nate. (deg'tnning with the first Change Daa. my intertst
rue will be based oa ~ "Index." The Index is tlx Rime Ratc a published in the Wall Street
lottrtnl "Credit i±•Iarkets" section, "Money Rata" robk. The Current index is the most recent
Index figure avttrlable an the fiRserult day of the last momh ofdu cakxtdar garter prior to my
loan's Oisbursertxnt Data a Change Date, whichever is brat. If the ttxkx is no forrgm evailebte,
you will chtrose s ~ttew ialex which is based on comparable information. I will receive notice
of this choice by you Before tub Change Date, you will calculate my new interest rate by
id 'f don Disclosure Smtement as my
PROMJSE TO PAY
i promise to pay ro your order. yoar sveessors, asslgo, sod any other holder of this Nola
all sues disbursed to ms or on my behalf under the tetras of leis Nnte, interest oa aueh
sums, late payment eMrges and cheek ratan fees as peoridM ie the Note, and soy
albwabk eottt you Tatar la eollecHag tMb Net0. Ineladlrq semtsaahk attoney fro. !
UNDERSTANDTQATTHIS 4S ANOTE WHICH i WILL BE REQtJfAF.D TO PAY, l
WILL NOT SiCK THF. APP4ICATION DF,FORF, READING ALL FIVE PACES OF
'PFUS NOTE EVEN iF OTHERWISE ADVISED. THE TEAMS AND CONDITIONS
SET FORTH IN THIS NOTR, COyST1TUTE TH L RNTtRR AGREEMENT BETWEEN
YOU AND.ME. I AM ENTITLED TO AN EXACT COPY OR THIS NOTE. MY
SIGNATORF, CP.RTfF1Ei TI[AT I l1AVF. READ, UNDL?:RSTAND AND AGREE TU
THE TERMS OP TIi13 NUTS. ] HAVR '17fR RIGHT TO PAY 1N ADVANCE THE
UNPAID BAi.ANCE DUF. IfNDF,R THiS NOTR WITHOUT PENALTY.'
trorgm, (lhe'9rkram'~ t0 the Cuniem Index. You can ro
subtraction to the tttsrat one-eighth of rote percentage point (O.l23Yz). Far example, the
Variable Rate for each queAm beginning Jnnuury IN will be daermined by the applicable
Prime Rate published an the preceding December I Stl4 plus or minus the Margin, rounded to
dte nsarast one eighth of one percent. Subject ro my tiroiu impasad by law. this rounded rate
will he my new interest one until the next Clangc Date. The Margin is dote.-rrnirted by mr
aedit history and the prtmettce of a cosigner. My new interest rete cart I become effective on
each l;ftange Date. If the Index is not published a not stood for any reason, then ttx Current
irtdrx stroll be detertnirted by using the immediately proceding published index. In the evrnt
that mars than one index u published the Index shall be wlcnlattd using the highcp mtt w
published. In no event mill the Votlable Rate exceed the trtaximum rate allowed by law.
TERMS OF REPAYMENT
1. Imerim Period •.1 am not required ro make payuunu dtoittg the Interim Period. You will
add tatpaid accrued interest ro the principal babna of the loan at the etxnmrnament of the
Repttytttettt Period. t may. hotvever, make psyrnents of interest which accrues during the
intmbn.Period in the mnrxmb shown oa my quanaly statemeau.
i Repaymatt Period -1 will rmke etmseeutive monthly imnllmenb in the tnnounts and on
the psymtstt due elates sbotvn on my monthly satements or in accordance with my ACH
autttoeiartioa form, rf i have clrosm w make my pttyrrxuts via ACH «amfm, until I hatT paW
all of tltc principal and merest noel any arbor elargrs l may owe undtt this Note. [f 1 am
unable m reyy my butt aaordin4 m the frame of the Note. I may request drat you modify the
terror of repayment. We tmy mutually agree m a modification and i f such modiFtatia resorts
in a postporiarrtsM of iasmllmanb for any pariad, intasat will cwttinue to accumulate during
that period. Any unpaid intettat et the w0 of the period w111 lx added to the prrncrpt! balance
of my loan.
3. Repayment Terms - I wig repry my loan in consecutive rnoruhly irtsnllments of principal
and intercet wlClllalld u the coromerreenrent of the Repaymad Period to equal the amount
ntsxanry to emonia the unipard prineipat balance (incuding eaprmlized interest) of my loan
(ru ofthe date of calculation) in 240 momhly imtellments of principal sad interest calcuhued
at rtes grcemr of ehher ten percrnt m the actual Variable Rue thtn in elTixt. 1 undersund that
immeu well stereo at the Variable Rete a toted is the "[NTERES"f" pmagtttph and the tool
numbm of momhly payments may he increased or decrcoed n a resort of changes in the
Variables Rue. Sines Interco atxrua daily upon dx unpaid prnxips16a4nce of my Ian, if f
make peymenu alts rm peymrnt due dues. I may trove addhionnl interest. if I have t+ot paid
my late charges, 1 will Ilan owe addit}ortd amounts tm'thote lam charges. In aueh case the
trtul number of monthly prymems necexzary to repay my loan in full may be incrcnsed.
4. Minimum Repayment • Notwitltsunding Repayment Team lisctd above, during the
Repaymen Period, the minhnurn monthly payment ofprincipol and interest on this Itwn togttber
with the mtnlmturt monthly paymaN an alt other MOIIRLA CtSHfnant shall be S50 per
month or the unpaid balance, whichever is leas.
S. Application ofPsyment - Paymenb received hY you will bt applied in the order of: collation
cant if applkable, Ise charges, outstanding interest as of the cifeetive date of the ptryment,
end then ro principal.
6. 1 have the right ro prcpny ell a wry part of mY laser u any tints withow pastry. if I prepay
the iron N pan, I agree to continttc to make regularly uhntukd paymrnrs emit all amounts
due ruder this lour arc paid
7. My obligation m repay this loan writ remain rn fact even rfl becomctomlly and pcrtnarxntly
dimbled ar dies.
LATE CFIARGFS, COLLECTION COSTS b RETURNED CHECKS
if permitted by bw,1 well pay a late charge rC I fail b make any ptut of an instalment payattnt
within t S dnya afkr it baoma due. I will pay only oae Lte charge for m Tess W lmtmt peymrnt,
tegnrdkss of the nntnber of days it is Wes A bte charge may nd exceed St S or 5% of the
tatpaid urtotun of the installnrad, whidxvar is gssum, not to extxrod SSO, with a miriaaum
rJutrga of S l0 except that fa any payment of f25 a lases in defiult for a period of m less than
fiflaen days dx tare eharye shall not exseed fS. i agree to peyyou reasonobk tutrottnts permitted
by law, including n.asauble attomey'a fees. not m exceed 15%of die amount due sad payable
under this Nme, and coral casts, while you iota in enforcing the mrnn of this Nate if I am in
default. Ifmy Payment I made a this Note is not honored faits full amount, you may charge
roc a handling flee of S25 plus charges asae>aed by arty imtitution fa protxtssing a rcfrtud
irmtrtrtnertt. The collal'an coats may be added to my principal balance hereunder and accrue
merest o the rett provided in This Note, whhotn nmia.
IMPORTANT NOTF. SiJRJp:CT TO APPROVAL
1. When you receive my signed Note, you arc not agree ing m lend me monry. [f you dtxidc m
titalte a loan w me, u your option yon will mail a loan chak or electronically transfer the
funds to my rcltool for me, unless requested by the school w smd the check diredlY m me for
my MEDCASH+ loan. You have the right not to make a Iron or to lend tm ttmovnt tar than
the Icon amaatt tegtxsted, I agroe to accept on amount Ica thorn the loan amount requested
and m repay that ponian of the loan amouat re~rated that ytw ecanlly lard m toe.
2. A Rer you agree m make a Inn m me, you will send me s d'tsclastaa uetsttreut. in addition
to other iafonttsdnn, the diaelostae statement will tell the the ttmotsN of my disburaeattmt(s).
3. 1 will review my discbsun smteraertt apart rxoitirtg it and well eoatoet you if i have any
qutstinrm.
4. My obligation to repay amttunLS advanced la me tracers upon my receipt, or my uhool't
nettlpt on my behalf of funds d'ubursal by you. 1 will repay roy Note actwrding m the terms
desaihnd under dte'Terms of Repayment" sscGon below. ICI oat aW satisfied with the terms
of my loan a approved, I may canal this Nom and ttrry diaburstxtsrnb. To anal Ibis Noe,
I must contact you in writing within I S days of nxciving the diaelmtae amtemeat a caaigner
erotica. trdify eery school, trot rndorse any loan chock trod ensure drt any loan disbttrsrmntts
ate rearmed to you Cancelluion of the Note does not ohm my obligation m repay amounts
ad varaxd to me a m my selwol on my behest f. 7 understand that 1 rosy also wheel or redoes
the size of any loan by informing you rn writing within I S drys of receiving the trppmval letter,
disclmurc staement or arty subaquent disburstanent.
if all nr any portion of loan funds dixhtmed are returned to you by the school m me within 30
treys of the date d'tsbursad, you will charge no interest a charges on the ibnda retuned. l
undersmnd that ifn ion is cartcelal, l will have to reapply to obtain a new loan. I also fully
tritdetsrand that the fiilurc to tornplete ttx edtxation progrem tedertaken by me does net
relieve here of any obligation on this Nate.
neFlNlrlons
l: Disbrtrsanml Dau -The "Disbaseaxnt Dote" is the date a which you lend arorxy tome
in uauidaation fm my Nme and will he the due shown on rtry Ittan check orthe date the toner
llinds ore elacurmically tmnsfined m mY stitoul.
2. Jntmim Period -'ilx "In[txiro Period" will begin nn the iniiral drsbarsemero doe and will
std an the date which is: (a) for t:DCA.SH, CRADCASA, RXCASH, and LAWCASA
programs, I im Aays afla I grod»ue m odttxwlse [sax to >x enrolled in at lerw half--tithe
study u tits seltool ranted on fix Note or say ether school pertkipeting is m eligible F'FELP/
CASHLasa pmgram, (b) If 1 was txniCnsd m a lass tMn half time student, I g0 days alter I
graduou or odtmwise eeax m be enrolled et the sclronl rtatne6 on Ilea Cash Application and
Promissory Notr form or any other school participating in m aligiblc FFEI,PlG4,SHLoan
program or 7 ywrs afla the due of my first Ian d isburscment rf I am will attrndhtg school,
(c) for MEI7CASH and MEDCASH+, Corry eight months aQer ! gntdwk, not to exceed
seven yams aflm my first M EDCASII l.wn disbursement, or 1 f0 days after I otherwise case
to ba enrolled in fldl-time study W thescttool ranted on theNote ashy other school participating
io m eligible PFE1.P/CASHI.oan program.
3. Repayment Period -The "Repayment Period" will begin on the day after the Interim Period
ends and will condnete until the tttwt is paid in furl.
4. Stamment Period - If l have rtes elae[ed ro repay roy Iron by ACH ttansfm a iC 1 haves
revoked my ACH authoriution, I will receive morohly stneements fm my Iron u the addms
shown on your retards (see "Notices"). The period of time cowed try a surterrrent is wiled a
`5tatemmt Period". Dori ng the Interim Period, I roil{ receive govteriy smtamertb on my loan,
after the first disbursement. Tfx giwrtcdy swemenb will cover the period beginning on the
Dixbwscmero Deft aril theiseflcr on the lira[ day of each January, April, July and October.
Ahytime i revoke myACH amhoriration. J will as soon as prettiest receive monthly statements
at~tlx address shown on your record+•
S.~ Origination Fee - "Origination Fa" means a to of SY. of the principal ammmt loaned
hereunder na m exceed S7S paid by me to you m set forth below.
INTEREST
I. Accrwl of Interest -Interest will accrue form the Disbenrterrtent Date until payment in full
ORlGiNATiON FEE
You may charge me m Odgination fee of S% of the principal amount loaned hereunder not
to exceed f7S which will he deducted tirom my fast disMvsemrnt. 'Co the estrnt permitted
by law, 1 will not be entitled to any refund of any Origimtion Fce atlm my disbursement
check has been cashed, or f f my Ian is diubursed by Electronic Funds Tnnafcr or moiled by
mortar chock attm the School rgtplies the proceeds of my Tan to my Student account.
Page 3 of 5
Wt10LE LOAN DUE
'fo the utrnt permitted by law, t will be in default and you have the right to give ere trolls Urat
the whokoutstandittgprincipal6alanx,tttxruedimctat,endaUaherenwunppayobkmyou ORALAGREEMENTS OR COMMITMENTS TO LOAN MONEY,
undershe [cents ofthis Notq are due erd payable atttace(subject w any law which may give me
' EXTEND CREDIT OR TO FORBEAR FROM ENFORCING
a rigtu to curt my de[suh) iC
t REPAXMENTOFADEBT INCLUDING PROMISLSTO EXIEIVD OR
l. (fail tv makc any urontbly payment to you when thx; a 1 1 fail to notify you of ^ change fir' 1j~7~I~`p~NOTEN~RQ,.A$I.E.T01'ROTECTYOU
i n my name, addrt'ss, m school rnrolhnrnt sotto within ua days atbx a elmtge occurs; or
3. 1 break any of my other premiss ht this Applinfton and Nos; or 4. Any bankrupny (BORROWER(S~)AND 11$
(iENDER)FROMMISUNDERSfANDING
proxcding is begun by or agstinst tree, or I assign ally of my assets for the benefds of my OR DISAPPO[l1TMENT, ANY AGREEMENTS WE REACH
creditors; or 5.1 Duke any foist wrimrn staument in applying for thk loan or u any rime during COVII~RIIYG SUCRMATf'ER$ARE COKTAINLD I]1j'I~S~iNRrj'I11fCs
the 1 ntetim or Repayment periods; or 6. I foil ;o [emit to you any refund of loan proceals; to 7,
I default under the terms of any other promissory talc or agreerrrrnt which evidtncp my W~CRl~TI~E~~D LXCLUS[VESTA'IF.MF.IYI'OFTHE
'
'
obligation to you. AGREEMFrr7
BE1
VNEENUS,FJ-;CEPZASWEMAYLATERAGREE
If T dcfuult, I will be required m pay interest oo this kern occruing alter default. The interest rate IlV WRfC1NG1'O MODIFY 11:
aflcrdefettltwillbewbjecttoedjustmentintheamttenauuttxasbeforedoCadL Alao,ifldefault, -A .t IA R ~ LENTS O~lliy; Credit appliams have the right to prohibit use of
disclosureoCinfrxmatan aboru my leer[ rota[tsumerrcportingagett.iestnayadversclyaIIrctmy iafonnatian contained in their credit file in eomxetkn with trenaactiom they do rest initiate,
credit Wring. The tea uacist this ri ht
y y g by notifying the eonsunter uerlit reporting agency, A married
iVOTT CFS opplieam may apply fa a separate aaount, if an tpplitatd's credit cgttat vest dccllrted, the
I will aestd written mitt so you, or any subsequent bolderoflhis Note, widtin ten days aRer any tppliant refuaad atxtuatuoffer, the aaatru was declined, or [irate win as unfivnrsble
change in
tarty rode to the accawt lord the deaiaion was based, in whale or in part, on infomtatan
change in my name, address, school enrolbnatt err ACT( atxhotiation status. Any rrolirx MrtWitted in a consumer credit tepoA, the applicant has the right m obmin a free copy of the
rcgmred to be given m me by you will be effeaiva when mailed by Pau class [toil to the latest
address you have for me. otmwttrer wadi[ report forthecnxlkreportirsgttgenty within 60 days. Theapplitsmt oho btu the
right m obtain a M of the co u red' !
ADDITfONAL PROV1SlONS
1. The ptoceodsoCthis loan will be used only for my edttcatiaml etytmx(s)at the school lisu
on the Note Form.
Z- 1 urtdasmrrd sad agta that shin alttwtiortal loan 4 not disdurgeabk in borekruptry, ex
ptrrswnt ro I I U.S. Code Section 523 (a) (>h, due to tls Fau duct [hie edtrcatiotml loan invot
otre or mac o(Ihe following: the loan is made, insured or gtmnmteed by a govcvarrremW unit, '
made tinder a program fundal in whole or in port by o brovcnunettml unit tx nonprofit irytitutio
or is rcaived as ao edutaliorul benefit
3. l authorize you and any edueatioaN iastimtior4 to make inyuiriea tv err reaportd m inquir
from my parents or prior orwbseq tern[ Lenders or holders with mptxx W [try kart applitsnion
ialeted documents. [ tadarsbtd drat ifthe bkphone number 1 provider st rtny dine b for a ocllu
tekphorc ur other wirt:tas device. I atahorire you, the drool, the gwrantor, or their agoras
auigns to carrtact me a suds number regarding this note using an eummkie telaplrotte d'iali
system Dean rttficir! or ptaccardod vowe trtaargle. I abo authorisxyou m rrJtwse information
make inquirla m the pmosn I hove Ibmd in my loan applipUon es refetetrces, for the purpose o
learning information about me. (ttntlrorize you to retvse utfortouion and makc inquirim b
nffilisted tilted parties dtuirtg the Dermal emtrse pfbuainas in the origirotion and servicing nt '
loan to the fops[ extratl parahud bylaw inelttdiag arty exception thereto.
a. !authorise You m forbear eery payments of principal and inkteri on aqy ofmy CASI.1L.osas i
tepaymrnt drama to align die Repaytrteml Periods of all my kara. 1 ttttthorae you to add any
unpaid interest to my prircipl baiaoce during this aFigmxrtt period.
S You troy postpone eery payrtreots i4 me avant I am affected M a Ns-iorml or Nattrrsl disaster at
deehved by FFJvtA upon ntxloe to me. l may tkdine the poupoaemertt by rtotia m you.
6. My raponaibility far paying This Note is trtsatl'ewad by the IiabiGty of eery other person ro me
or by yotu failure !o rrotily me that a teyuirerl paymerst has not been made. Withow being any of
your rights under Nis Application oral Nub you may accept (a) Isle psymemu, or (b) as permitted
by law, Partial paynrersa, even i f rmrked "pyment in full". You may tkhy or Cdl k esatax, or
waive ary of your riyty on soy oocaaion without !wing your amitkmant to exercise the right u
any futtac time err on arty future ocratlw. You will rxM be ttMigslal to tmtke arty demsrd upon tree,
send rtte arty notices. preseru thu Nate m me for psyrnrnt or oxtke protest of oatpayrnrnt b me
before suing m collect on this Appliraion and Note iFl am in delttdt, and m the extcrtt permitted
by appliubk Isw, l hereby waive arty right 1 might otltttrwise have b requite etch tuxiortt
7, THri PROVISIONS OF THIS APPLICATION AND NOTE WILL St GOVERNED
DY FEDERAL TAWS AiYO TtfB LAWS OF TTIE STATE OF MISSOURI WITIIOUI'
CONFLICT' OF LAW RULES E agree Ua: any suit l bring against you (or against any
wbxqucot holder of dos Note) must be brought in a eottr[ of eaopetent jttriadictioa in the Murry
in which you raairWin your {or suds wbsaptent bolde- mairaains its) prircipal plaoa of btaiseR.
B. I may not auign thu Note or arty of its benefits or obligations. You wy assign this Note al
tiny time.
9. Ifany provision ofthe Note is hdd invalW a urtertftrrceabk, that provision shall be ctmsidraed
omitted floor the Nob wihout eff~ting the validity or cnfotceabiGty of the reatairtder oftheNote.
10. A provision ofthe Neu may Doty bu modified if joimly ~d upon in writing by you std me.
Any modification will not affect Use validity or enCotcabiliry ofthe remairderof IhisApplicetioa
sod Note.
1 L ! undt:tst:od that you moy elxt m puxlrre a default itaunnrr policy m reimburse you in the
event that 1 deCsult on this loan Ifthe insurer, is requited under its irrwtarxe connacs to repay my
loan, Ute iruurer veil I btsome the owner of t~ Nok and u my creditor will lave Vi rights of the
Oigioal Lerxkr or subsequent holder m rnWru the Note agaitW me and my cosigner.
12. I must update the iaforrwdon on der; wheueva you ask me ro do w.
13. If MOli1:LA is required attic[ its gturmuy agreement m repay my ]oati nr ii MOl(Fr •
purohasn my loo from the Origimting Letdv, MOtff.LA vela herxxae the ownsofthisNme and
d^Y wPP~na or related dtttaanrnts, irtJtding du two application and as my creditor wiU have
ell the righa of the Originating Loader m enfottx the Note ogttiast the or my Coaigtxc
Is. 1 authoriu you, m ust my SSN to verify my idetuiry, surd as an aceoum otanbtr (idtxtG(ia)
throughout the life of this loan. As an identifier, die SSN is used in suds activities as determining'
my program eligibility, ecrtifying my acltool tutcrdartce std student sorrels, tletetmitting my
eligibility fw defrnrtrnt of repayment, and for tracing acrd collecting Crum me in Bate T booome
delinqurnt in my Iwo poyments or 1 default.
DY na mar c u report ram arty athar emrsuore[ cretin nportrng
tgeney whidt txrorpiks and maiMaita ales on oomumrn on a ttationwidc basis. Additimtnlly,
the applican has the right to dispute tlu accrtrstcy or oomplerertesa of any infomunion in a
d cattsutmr tasd'd report hrmichcd by the comumer credit reporting rgctuy.
MwINRIt_LC(DSN(SOYL•Y: Cpnpnnrrlteposb(ctadgtepeets)muybroEYittedintrottrteaion
«pt wilhthisapplicettaa Iflsorequest,(I)Iwillbeinibrmedwhetberarnotcottsunrrreponswam
ves obuittad, and (2) if reports were olrairted, f will be informed of the llama and addresses of the
y Mnwmv reporting agencies (ctediebtusatts) thm famished the reports.
n, sH10 trrresDt?trrs ONLY: The Ohio laws aguimt disttitrsisution tagtdre dart all creditors
rmke erodit egtrolly avaibrble [Dail credo-worthy cuctoattTS, and rho credit reporting agencies
Ks snairwin acparau credit bixoria oa catch individual upon regtteat "the Ohio Civil Righu
and Commission administers compliance with this law.
tar NFW YORK R(10 . IC AND A(~,() Y '. a,tONT R~l(jYN'('S ONLY• A wnsumer
and report {credit report) may be obtained horn ^ concwtter•teporiittg agenry {credit bureau) nr
ng comtoction wide this Applicafron. tf I rdlueat (1)1 will be informed whether or not cunstrmcr
acrd repom wen obmined, and (2) if reports were obtuirted, t will be informal of lire name and
f addseaNS of the ctedh bureaus thu flrroished lira reports. Kthe Appl'scaUon is approval, n
non Mnstmta tacdu tepori may be requested or used in crxaycUw with tenewa6 or cxtayiow of
tltu aey credit for wtdch I have applied, revisvrirtg my loon, taking collection action on my Ian, ur
legitirgata pttrpaaes associated veldt my loan.
n MARY „s-wYnR~GDRN7'SONI Y:Ywelax5ubtitlelRCredltGrantaClosodGndCmfil
Provisiota,oPTide I2 ofthe Cortutretcial LowArtickoftheAneotued Codo ofMarylmd only
to the utrau trot irteoasisuru with t~ US.C. ¢g5 and rehbd reguktiorts and opirirorts, which
we expressly reserve.
j~jgygJF;~g,Y ueS(D~7'S ONLya The xaion headings ot'tbis Note are a Whle of
eontant: and not contract tertro. Pbriitxu of this Nato wish roferettces to utiorm token to the
utmtof~tplicabkkwapplymuenarpractitxxtMtNewJertrylawpermitsorrequirea. [nlhis
Note, acy or practicer (i) by you whidt arc or.tnuy be permited by "applicobk law" ere
permitted by New krsey kw, and {ii) that may or will ~ taken by you unless prohibiud by
"applkabk bw" are permitted by Now Jt:raey. '
wt-~ySIN RtrclswNTi, NLY; No pevviaion of any owrital property settlnmr:nt (pn-
trtariW agnaatpai), unilasenl statement urxter Section 766.59 of Urn Wiuvwin Statutes or
Mart daetts under Seaton 766.7D advtstsely affMS the interest of the lender unless the )order,
bdore the time that the lean b approved, is furritshod with a copy of the rttariutl property
si~mertk a aitataamt a dense or has aeotal kttawkdge of the adverse provision.
~IFORN w Nn srTAH RI_+.S!DLn"I'S ONI V• As to toted law, all
q by applicants ore
hereby rtolifkd thst a rtegiaive credit report nikcUngon dteiruedit record may be submitted to
r credit reporting agency if trey fait m fulfill the bmtt of tittle cndh obligadonc.
FL!IERAI, NOT2CE'~O COSiGN~ TI(e co~Der is being asked to
guaraatae this debt. ThhTY carefully before agreeing to do this. If the
Borrower doesn't pay this debt, the cosigner wig have to. Be sate the
co:ignercaa afford to pay if necessary, and that the cosigner weals to
atxept this responsibility. The cwigaer may have to pay up to the full
amount of the debt if the Borrower does not pay. The cosigner may also
have to pay late t~targes or collection costs, which iocr>stttse this alnouaL
Theleader orholder ofthis loaac~o ta/lkct this debt from the cosigner
without th'st tryhig to t~lleet from the Bortvwu: The tender or holder of
this loss can use the same collection methods against the cosigner that
coq be used against the Borrower, such as suing the cosi~Der, garnishing
wages, etc. if this debt is ever in dtisult, that fact ttmy become part of the
coJiigaer'g credit record.
This notice is sot the contract that makes the cusigoer liable for the
detn
PR-Sams
~Rse a or s
PROMISSORY Nt1TF.l C,OSIGNF.R'S COPY
In [his Applientia wed Promissory Nac the wools "1", "me", "my" std "mine" mean the
ftormwer andror d,e casigrxr, w tlx enmext indicates. "You", "you" and "youq" mean the
Originating Lender, a iu succesors ford assigns, and troy other holder of this Nae, including
MOIiELA.
! sutltwitx the Leader. iq servicer, or MOHELA as the gttaantor of this ban, or the agents of
any ofthem ro invatigJps my ereditworlhittess, to rcgrrest and raeivo ercdibrckted infomtation
about me from odrars and ro famish infnrrrurtbn co»cernittg my tan a appliasion aced rclaud
doeuttrntq to cmrsttmer rcpoping agertciss and arbor psaarts who may legally receive such
information- t ardharirt my txhmri to restive, provide, and confrrm itrftxtrution regarding my
attctdancc, financial aid, or rnrolttnan sofas for consitkaation of dris applicatbn.
PROMISF, TO PAV
l premise m pay to your order, yonrsaexnsors, assigns, aced say other holdv of this Tote
aU rams d'gbunsed to me err as my be\al(uader fhc terms of this Nora iaterat an each
soots, Tats payment charges and check return fees as prnvidar! in the Note, and any
altowabk aroia you leeor is soRculag thk Nae, ineladlmg nasoaable atbraey less. 1
UNDERSTAND THATTHiS IS A NOT'F. WIiICH 1 Wlf,l, BE REQUIRED TO PAY. I
WILL NOT SICK THE APPLICATION pF,FORE RRADINC ALL RIVE PACES OF
TH15 NOTE EVEN •IF OTHERWLSE ADVISED. TH6 TERMS AND CONDITIONS
SET FORTH IN THISNOTF„CONSTffUTETHE ENT'IREACREF,MENTBl4fWEF,N
YOU AND ME. I AM ENTITLED TO AN F.XACT COPY Oi THiS NOTE. MY
SIGNATURE CERTTFiTS TI[AT i HAVE READ, UNDF.R.STAND ANA AGRRE•TO
THR Tf.RM3 OF THiS NOTE. l HAVF. TN6 RIGHT TO FAY 1N ADVANCit T1iF,
UNPAID DALANCR D1fE [fNDF,R THiS NOTR WITHOUT PF,NALTY.
Th1PORTANT Nf1TF. SUHJECT TQ APPROVAL
I. When you receive my signed Note, you are not asreeino to lend me money. If you deride to
matte a lout to toe, at yore option yet will mail a ban check or electronically tremfer tlx
fiords to my sctaol Forme, unless rcgrreped by the seltool W send the chock directly b me for
my MEDCASHt loan. You have the right rant to make • ban or b lend an amourtt less that
the loan antouat requested. 1 agree to accept an atnoum tcsa then the kern atnoum regeressed
aal to repay that pnnion of the loon nntount rcquestad that you actually kai to me.
2. Afkr yar agree m rttoke a tan ro ms, you will >KM me a discluartrc statement. in addhion
to othxr informaion, dx diulosurc staten+cnt will felt me the amount of my disbnnement(s).
3. !will review my disclosure sutmtettt upon reeciving it end will enntxt you if 1 have any
qudtiora.
4, My obligation [o repay amounu advanced to me occurs upon my receipt, or my school's
ieecipt on my behalf, of fitrals disbursed by you. twill repay my Note act:ording b the arms
dtYCritted undo the •"ferrns of Repayment" stxtbn below. If I tun trot sa[isficd with the terms
pt'my Ian as approved, I may tsrtccl this Note and any dixbunemena. To cancel Ibis Note,
I must contact you in writing within I S days otrcttiving the diw;lowrc sgtoner,t or cosigner
cola, notify my sch,x+l, race endorse any two check, and tmstse duo nny Ian disbursemmu
ire rctraned Io you. Carrceguioa of the Note totes not alter my obligation ro rctuY maoturq
idvantxd to me a to my school on my behalf. 1 undenlMd that 1 may also cancel nr reduce
the s'ra of rnY loan by in forming you in writing within 1 S Joys of receiving rhr approval Icaer,
disclnsurc stuement a any subsequent disbtrrsenrent
! f nil or wry portion of loan funds disbursed ore rctumaf to you try the arJrool a me within 30
days of the tWe disburWl, yea, will cMrgr nn ineerest err charges on the Rmdt returrretl. I
undentard that if ^ loan is canceled, l will have to reapply ro ahdin a new loon. I also fully
rindersumd that the failure ro cornplttt the eduction program nnderukrn by me does not
relieve me of any obligatia on this Nae.
D BPI NiTIONS
1. Disbrvsemem Dau • The "Disbtutentart Date" is tlq dale on which yew Irnd money to me
in cartsidemtlm for my Natc ant! will be the date shown on my keen clt«k err Iht dtroe the loan
funds arc eleeaonieally tnrofrrted ro my school,
2. Inurim Period • The "interim Period" trill begin on the initial dishuncment data and will
dad on the date which is: (r) for F.DCASIl, C.RADCASH, RXCASH, and LAWCAStf
programs, 180 days after [ gtaduau or wtxrwise'aasr to be enrolled in N tercet halftime
xtudy nttlx sehoot named on rtx Note or any otfxr school panicipsfing in an eligible FFEI.I'i
GA.SJJLoan program, (h) If I was certified as a leas than half time student, I80 days otter l
gradsou or otherwise cease to be enrofied w the sciaol teemed on the Crglr Applimion and
Promissory Note (arm a any other scha+l participating in'sn eligible FFliL1'ICASNIoaa
program or 7 yeah afkr the riots of my firn Ian d isbumement if I tort still eucnding xhwt,
(c) for MEDCASH cad M@DCASH+, Pony eigltt months aRv I graduate, trot to exceed
seven yeah aRer my first M EDCASH Laos disbursement, a 180 days after 1 ahenrise cape
to be enrolled in idl-time study at the sdwol named on rhr Nou err any rttlrer school participating
in an eligible F'FELI'/GISNIerr+ program.
J. Repayment Period • The "Repayment Period" witi begin on the day after the Intuim Period
cads and will axtlinue until the loan is paid in (all.
1. Sutemem Period - if (have cwt elected to nepny ray keen by ACH transfer or if i Mve
revoked my ACH suthoriartion, I will receive monthly s»tements fa my Ian at the addraq
shovm oa your reca:da (sa "Nalco")• The period of time covered try a sntrment is ailed a
^Saummt Period". During des tnrcrim Period, (wilt rcaive qusnerly patemcros on my loan,
aAtt the first dishusement 'fhc quanrrly sMemenq will cover the period beginning on the
Disbrtnu,tent Drte and tlereaRa a the fiat day of each Janwry, April, Juty std Oerobsr.
Anytirrc I reroke my ACH aurhoriyarion, l wilt u soon as pnctiul r«eire monthly smements
a[ IJR address alawn on ytwr records.
5: Origination fee • "Origiwtion Fee" means • fee of S% of the principal amamt lomned
hem,nder not ro exceed f75 paid by me ro you to set forth below.
INTEREST
1. Areruol of Inters - imerrst will accrue from the D',alwrument Gate anti) p.ymem in full
al tlx Vuiable Rau described below in section 2 (the "Yuiable Rate.")
2. Vxritrbk Rwe - I will pay a Variable Rate of imsrcst. 7'he interest rr;e I will pay will change
ern the lint day of January, April July and October i f the Current Index (defined below) clgrtges.
Beech bate on whitd, mr interest mte could changt is canal a "Change Date." The initial
interest rate shill be u stated in my initial disclosttrc statement (the "Disclosure Sldtement")
which it herclh%itrcorpnrued imro this Nac. Beginningwith the first Cfiange date, my imaet
tttk will ere based on an "Index." The Index is the Prime Rau as published in the Vfall Street
Journal "Credit hbtlteq" s«tion, "Money Rata" ruble The Curtrnt irdcx is rhr most reten[
Indaa figttrc avsilaMeon the tiff«mh day ofthe last rtrortth of the calrndar quarter prior m my
4rn'sDisMaaemanDauarChartgeDate,whidrevarislauc Ifdteindcxisnolongeravailabk,
you will choose a new itufex which is baxd at twmparabk information. 1 will receive notice
of this choice by yar. Before eacfi Change Date, you will cdndue my new imerest rate by
adding or subtracting the: percentage per aaman identified an myDisclosurc Statement ss my
margin, (the "Margb~ to the Curtest Tndex. Yew trill then roemd the rtsuh of this addition or
subtraetioa to the nearest oneaighUt of one pertxnntge point (O.IZSYe), For exaenple, the
Variable Rttte for aeh gttaner lteginnirrg Jamtrry Ist will be deurminrd by the upplitsbk
Prime Rau published on the: preceding Daember t5th, plus or minor the Margin, rotttdcd to
the nearest one eighth of otte percent. Subjat m arty limits imposed by law, this tvunekd rate
will lx my new interest rate until the next Change Date. The Margin is determined by my
credit history and the prear« of n croigrxr. My new interav rate will beoornc effective on
each Change Date. If the index u race published a not sated for mr reason, then the Curtrn:
index shall be detertrtined by eaiag the immediately preceding published lrtdex. In the event
lilac more than one Index is published, the index chap 1x calculated using the highest rcu so
publisheA. In no event will the Veriahlr Rau exceed rhr ms:imam rate albwed by law,
TP,RM5 OF REPAYMENT
1. interim Period -!tan not required to make pmynsems during rhr interim Period. You will
add unpaid accnrod interest to the principal balarxe of the bon at llx commencement of fire
Repayment PeroA. 1 may, however, make payments of interrtt which accrues during the
Inxrim Period is dx amouna shown nn my garterly stalemrnts.
2. Repryrttent Period • t will Drake rntts«udvr momhly intstallmena in the amouna and an
the payment due dates rhown on my monthly statanemx or in accordance with my ACH
authoritadion form, iCl have chosen m make my paytttenu via ACH tramier, until I have pai0
VI of eke principal and ioterest and any other chugs I may owe under this Nou. I (1 mm
arable a repay my loan according to the tertru of the Note, l nary rcquat text you modify the
turns of repayment. 1Ve may tnutw[ly agree to s modifiation and ifsuch modifiui,nn results
in a poppwemem of imullmatq for any period, interest will continue to sncumularo during
that period. Any unpaid interest at the end of the period will be added to the principal bakrxe
of my Imm.
3. Repayment Terms • l will repay my late in consecutive monthly instatlmenq of principal
end interest calculated a the commencenxnt of the Repaymem Period to eq,ml the amormt
,racapry w amonire the unpaid prinripal balwKe (including cnpinlized imtreat) of my Iwo
(as of the date oCcaleuletion) in 240 manthty installmtmq uCprincipal and interest calculated
at the greater of tither ran percem or ltx attual Variable Rate then in effect. [ untkrsurd that
interest will aarue m the Variable Rate as stated in the "INTEREST" pamgrnph and the tool
number of monthly payments may be increased a decrcttaed as a rcsuh of changes in the
Vmlable Rau. Since intt:resl unsves daily upon the unpaid prirreipoi balance of my Inan, if f
make paytttentt otter my pnymc,tt due daus, I may owe additiowl interest. 1 f 11W ve eta paid
my lea cMtge, t will abo owe additiond amaums far float tau charge. In such use the
foul number of monthly paymrnts necessary ro repay my loan in full may be increased.
4. Minimum Repayment • Notwithstanding Repayment Terms listed above, during rite
Repayment Period, the minintttsn monthly payment ofprincipal std inurcst on this loan agetber
with the minimum momhly payment on all other MOHELA CASffloaas shall be f50 per
month or the unpaid baknra, whichever is less.
S. Appllation of Paymrnl - Poytttatts r«eived by you will be applied infix order of: collection
cusp if appliable, late charges, mwmnding imene[ u of the effeetivr date of the payment,
and then to principal.
6. 1 hove flu right to prepay all err any pan of my Iwo u any [lore wi[ha,t penalty. [f [ preMY
the loan in part, I ogre. to cominue to make regularly scheduled payments until all emounq
Jut under this Ian are pu'xL
7. My obligation m repay this loon wit) renmin in force even if I lxcomc towlly and pcrnanently
diwhkd o. die.
LATE C1IARGPS; COI,I,FCTfON COST5 & RftTURNED CHECKS
Ifpermitted by law, t will pay a late charge if i foil to make any pan of an insullmcnr payrneni
within I S drays aRer it hecnma dent. twill pay only one ktectmrge for an installment payment.
regardless of the number of days it is tote. A Ina chtrge may not exored SI S or S% of the
unpaid ornount of the insallment, whkhevcr is grotty, not b cxc«d f50, wi sh a minimum
clattp ofS10 ax«pt that fbr any paynxnt of i25 w less in defauh for a period of no lest than
fiRsen days dx late chnge dull not exceed i5. I spec ro ptry you reatonaWe aaauna parmiaed
by law, including nagonable aanmey's fees, not ro exceed I S%of the amount due and payable
under this Nests, and.mun coq, which yea incur in enforcing rhr terms of this Note if I am in
default 1 fatty paymen! f mode on this Nnte is not honmred far is fuN amount, you may etatge
me a hurdling f« of f25 pitta charges nseaed by arty iratitutian for pracrssirrg a rclaud
inainrrnren:. The eallettion taps may b: added to my principal balance hereunder and accrue
inlrnit at the rate provi~d to this Notc, witlau notice.
ORIGINATION FEE
You may charge me en Origirutim Fee of S%of the principal amount loanretl herewwler rat
to exoaed f73 which wiH be deduucd from my first dulwrunttm To the extern permitted
by law; I will not be entitled to any refund of any Origination Fee afar my disbursement
cheek has been cashed, or if my loan is disbursed by Fkctvnic Ft.nds'Cransk: or mail:d by
master cheek. after the School applies the pmt'«ds of my Iwo to my Stndcnt aecotmt.
WHOLE LOgN DUG Page 5 of S
?o ax 4rtMt pcrotiuerl by Li w, 1 wi114: in defies h and you have the ri + t W •ivt me
the whole outsttrnlirylprincipal balance. ~ 6 notice drat O~ACREEMEIV
undo the tares ofthis Nate, arc due and a~nred interest. trod all other anauny payable to you TS OR COMMITME
erightW CUre my defaulQ if: payable at orrce (subject tvany bw which rtuy give me EXTEND CREDIT OR TU FORt3EAR Rp ~ FORC[IEYC
f, t fail to nnkt aay mataily PariMmt to you when due; or 2. (fail to noti ~'PA~ENTOFADEBT~(CI.IlpttvC PROMiSF.S'It0
in my nettle, ttdt(rtas, or school enrollment status within ten days after a c fY )nu of o change ]~~,y~~ DEI3TARE NOT SEND OR
3. 1 break any of my other promirts in this APMication and Note; harrae ~~~ or ~~It ,.~ P~
proceeding is begun by or or a. Any bantntlxey (~RROWER(S1)ANDUS(LENDER)FROMMiS OTECTYOU
creditors; ors. f makean fal~~ me, or I tmign say of my asxts fur art bencfiy of my OR DISAPPOINTMENT UlYDERS'I'AIVDIIIC
thelmerimorR a Y ~"~ltememtoaDPlYit>gforthisbonorstanyumadurin + ANY AGREEMENTS WE REACH
! defauh eP Yment Periods; orb. 1 fail to remit to you any refund ofivart Proceeds; or ~ ~~RIIYGSUCHMA7TERSARE ~.'t)t~^I'A[~, D ~
obligationWto ~~te tarm~ ul'arry ultra promissory nee or agrt:ement wFildt evidences roy ~~''ICI'S~~E~OIVIPLEIEAND~{CJ.~ISIVE ~ WRTI'i~1
!f i default, I will be required to p.y interest on ttris loon AC'~EMENT$,~'fyyEEN US, IXCEPTAS WE j~]pyEM~~OF]'IIE
aRerdetaultwillbcsubji+cttoad'u nativingederdefauu.7lteituereserue 1NWI21'I1AJC7)OMODIFYI7: ~TERAGREE
dlsclostrreot'informatior,abo,al n+nrntinthespnemeunarRSbeftxrdefaWt.Aho.ifldefwh,
credit rating. myloentoaauumerteponingagaotip,,,~,advenatyaft'evtt s~~~'-QNIY•
mY infottmatioa aomaiaed,in their Crcdil applicunb have the right w Prohibit use of
NOTICF,S They ttyy uettix this ri n craiit file in cmtrxetion with uansartinm they do not initiate.
oppligm nu 81 by ratifying the carswner credit reporting agency. A manicd
I wnl send writaen notice toyou, orun su Y aPP1Y flK a saparms xtgmL (fan aPPllcant's credit request w•as declined, the
Y batyurntholderoflhisNae,withinkndaysalleran• appltcantratuaeda~~'~theaccouniwudeelined.nrthtue
chengt in my ttttme, address, school enrollment or ACH suthorizsuvn ) terms made to ate aaowtt and tlw dmisiun wac wesmunfavu
8e
eddrxssd to bt givrn to me by you wit I be etiective when mailed b RAC' Any naive conuintd in a cmuum ~4 in whole or in retell chrn ~ .
You have fur me. Y Grn class mail to the latest er credit report, the applitmt bas the r' Patt• on infnnruu
cumuarercrcditrepon for tltecrodit tepnninga ~ to obtain a free copy of the
ADDITIONAL PftOVIS10NS ntyu t° obtarn a copy of the oonsunrcr credit lKtrcY within 60 days. The rrpplipm ahq has the
1. 'fire prvcttds of This loan will br used oN fa m agettc)' which terror 'les and I rcP°n lion, arty abet cronstmter credit ropWtir,g
Pr ore mains files on consumers on a mtionwide basis. ndditiurral-y,
do the Nok Form. Y Y etltralional a the applicant has the right ro dispute the accurxy or tram ate
xptstse(s) at the school titled cataumercndit+epon funris}ted by the consumer credit ~ rKSS of any infiMmation in e
2. 1 wnkntand and agree that this edticatiortal kuar is na disc L-1
ptttswnt to (1 U.S. Code rsPoning agency.
Sa.Yion323(a)(g).duetotlsfadthat~s~adauata'nxJ(oanYnvolva with thisapplication.l~Coro~r~ons(enditrepnns)maybeobtainadinconnemion
orie or rerun of the following: the loan is made, iroured or ohsain n4urat+ (I )1 will be informed whedrer or not consumer rc
made undaa program fiatdcsl in whole or in we`d ~ a Sos'e+rrmawti unit, is ~ °d' and (2) if reports were obtained, !will be informed of the n Pons ixre
or is racivgl as an ad P1n by a goverrartetpa( unit ar nortpmfU aWilutitm, ^sutnrr rcptvnmg agetteiea (credit bureaus) that fwnishcd the erg and addtessav of the
J. ! audttaiss ucatioaol ~~ Sltill)~;i'$1>2Gt~Q'3 ONt Y• ' reports.
lento my Patetttt ro prioror tdrtretttrrwl inshmni„n, to make in4uirita to or capond tp • 'rurke credh etlually available toall c~rru Inaronhgc ~l Jist'riminatiar require shot all creditors
rcbteddxtmen~. Jttnd st~equentLtmdersorl,olderawith mspccttom loan ~~ mniot°in separate credo hiswries on each individuN~~and tltmendit rcpvttingaganeiea
eel neon aw,alast ifthcteleplantenumrbcrlproritkal Y aPPl~tronand Comatiwion administers com I' ~ rc4riast. The Ohio Civil Rights
q~+ other winks dcvim, t ruthorix tart' lima is fora eNlular P uurce with this bw.
assigns to caswct rot u You. theschwl, the guarsruor, ttrtheir tR$errb and Y 'A
system aanartitkial orprctecordcd void ~rding rhb ntne using an automatic kkPhorre diali ~^ (credit report) ma be obtained f A ctawumer
tne:solp. laboruthorise nti aamwclion with drisA roar a cvnaunrar-rcpprting agency (slit boreal in
make ingniries [D arc persora l have listt.•d in my loon you b rcle~e inkrrrarion wrd PMitatlon. if I rogues[ (1) I will be infamud whether ur not consumer
lettmiag inforotatian oboes me. I awhori appikmtian as nfarertcts, fly the repots were ohairred, and (2) if repay wen obuirrtd, t will bt inlisnncd of the nsmcs arM
r~liued third n' ~ YW m release inlorntation turd rnakt i Durpaseol' addresses o(the credit bureaus thst frtr+rishcd the report', !fare A
loan m the fulhrt estaru the rroroW volts; ofbusiness in the ngttiries to rran consumer credit pplicuion is aplxuvcd, a
Pamtitted by law ineludiu an ex . ongrrWial era! servicing of this any taedu far whiRCh 1 Iravayiµr~p ~~I~ ~ in cvmxnion with rcnawals or extensioro of
d• t autltoriie You to forbear principal and interest un a~irto~ ag' mare lied, rcviewi m loan. taleing collection action at mY loan, or
r%' Wytrrnry of I ui pugxssea asanciarcd with rot' loan.
repaymrnt status to align the Repymrnl Periods of al( my harts, 1 wYthp jm7•ay Cou bU'OORS in )_y(gRYLAND RRSSp ar+•~
~ Youa interest to my prhreipal 4tlantx during this aligmmem Y ~ arty (rovrwans, ofTitlc 12 ofthe C `You elan Subtitle I g, Crcdi: Gnrrwr Closed End CrMit
m'Y postpate ro)• paymeme in ax evert I am affected bP a National or Natural disaster u to the cxtrnt na i omt^~btl t.aw Article ofthe Annotated Codc oCMaryland only
~~ bPonlrt•AffA torn aadce w me. t mry dxlino the poatporxmarrt by notice w wa eapreasly ~~»cottststent with 12 U.S.C. §83 oral related regulations anti opinions, which
6• M res b PYb+$ this Note is umffirped
or byY~ Caihme to real tY any other Parson to rx ~W 'IRRs;Ir V a
h'mathotareyuired bydtefiabiti of ---~-+....~.~iSil?jrr~ON1.Y+'ryxsK,iunhwdi
Yourrighta rudarthisAppliration and Nola Paytnem ~ real ~a tmrlteap tttd not contract terms. Portions ul'Wis Notr with rc~ of this No[e are a able of
You taayaaept(a)Itrselrayrmer,[s,~yj~rmppm~ N a^tofaPPltobblawapplybactsortxsnicesthaNawJ ~aatoaainmstokcntuthc
by law, partial PaYm<nts. twee if tnanced
waive any ofYour payrment ia~~~ ~ay),Mrtt qor tlil to exarua, or ~ ~ y P ~~llaw, onrl iwlsiclr ore a may 6r p~muiuad h~ym»~licable !aw^ art
airy fuaae tfaxoron~ as arw occasion wiaraw loci taatcisa the ri t Petmittad b Haw () Ihal may or will be taken b
send me any notice, proem ~ Noce to arco fw~g na ~ obb~ted to amkvany dtsrgnd uponhma, °PPlkabb law" sea Parraitted by New Ivsay. Y You unless pro(yibited by
before stung to collect on arts payment a amle protest of tbrtWYmuu ra rot ~~S- t-'^"yp~=
AppliaGon and Nok if! tan is defauh, and to the extern mental agtaement), unilwcat~` n~z~ 41on of any maritN Property scnlement (pre.
hY applicable bw, t hereby waive any ri t i m' Pumitted eoutt decree under See[ioa 766.59 of the Wisconsin Syttua or
7. 77IE PRO VtS10NS OFT ~ ~" otherwise have to rorprire stteh actions. beR,rc the Sec>iort 766.70 advaaely sifeeR the imarost oftha lender un +}
BY FEDLrtw, LAWS AND N1S MPLI OTION ANA NOTQ WI[.L BE GOVERNED tune art the Iran is a ro lest the lends,
CONPI,ICT OF THE LAWS F THE STATE OF PP vod, is famished with a copy of the marrml proPerry
t.AW RULI.S. 1 MISSOURI W17'HOUT aarcanent, a ttwemam, a dam or lus ac;wl knowledge of the advent
subsequent holdero(thlc Note)mwt 6ea~as that any suit f bring agairut you (or against any Provision.
in which Yourtuinmin ughtinaCO1~ofcompttrntjeuiadictionintheeoun ~abYnoufiedthatanegasivteraditreporrnl-ec' As ~wr~ by low, all aPPlicmts are •
8. I tree na Yea' (a such sobsequat holderntrun4ins iu) priori ry ^ credit roporting age„cy if tma an their credit record may be tubmittet! tv
Y ttssrpa the Note or any of its benefit' orobl' P~Pbceofbusiness. they Cail w fttlfill the terotsuftheircraditobligations. i
utY time, tgaiom. You may atsigtt dos Note at ~~~~-N07'ICE TO O I ~ Q The casiguer is bejpg ggked fo
9. 1fanYprovtsionofdreNoteisheldinvandtnun guaranteethudebt. Think
emitted from rbe Nee without affecting eht y}idi ertforceoble, user provision shill be carefully before agreeing to do this, if the
10. A rywenforuytbilit ofthe GOa'ideOd $OrroWer doesn't pay this debt, the cosigner will have to. Be sure the
ProvisionoflhaNaentayunlybemodifiedif mu Y rt'"aindt•TOtrhrNmte. ca3' Hereon afTord to I
+YmWificationwitlnotatCocYthewlidityorenfo,pceaoji.yvn~,aarn~of~~YA°Ui~ P ponsib'Pay~p~atyrandthattheeosigoerwantsto +'°
and Noce. atxc t this r'es
11, (,,,,d PP ~}= The cosigner may have to pay up to the full 1-
erwnd,t,atyou,,,aya(xrro amountofthedebtiftheBorrowerdtxsnotpay The cos'
event teat I default as Purchase a default insutarree po~taa ct rctmbeuse you in ore have to pay late charge or collection c0,4tg w
tbisloan. tftlteitnurer,is underits' ~gt+el'mayalso
lOrigirtal tLetrdar ordl become the owner of the Nee and as my creditor will ha~ract w ~Y mY The leader or holder of this loan can eo ~ hlCfl iacrease ~~ amount.
~ l roust u wbsegtent Itchier to enfortx the Nee against tree and my cosigra~"' orthe without first trying to coJiect from the llect t61s debt from the cosigner ~
Pilate the mforourroo on dte vvlteaever Boarawer. The knderorhofder of j
13. IC MOHHLA is requbed under its j9° °~ rot to do so. this loan Ci10 nse the
purchases my loan Sam theOr' • $14ranlY °grae"'arrt w repay my loam. w if MOIIELA can be SamC c°lketion methods against the cos hoer that
any strppo,u,~ ur rotated rgntsung Le+ider, Mot~i.n win become the owrrerof this Naeamd wa nt!(1 against the Bonbwcr, such as suing the cosignsr,garnishing f
as the rights of the dO4~"u' 10~dtfi'o~ra leer ~~+Kauam ar,d at my ercditor wal nave $~' °t~' If tfiis debt 19 ever in defauh, tercet fact ma
l~• ( ~~~ Le casigner'screditrecord Y~omepartofthe
duvaga~uto~ 1l~ ~"Y mySSN to verifj• rnv ideyir , ~r~' ~°`~"y~"• ) Thts notice is not the contract that makes the cosigner liable for the
m, loan' t 4 mr rdani~es,~ SSN is ttstd in such activities as detcrtnGniriy debt,
Y PtoBram eliGbiliq•, certi$; m sc taxlana ono srudtnt status, dettrmimtig mY
eligibility Car deferment of repaymrrt, and for trtieing artd collecting Gam me in core I become
delinquent in my loan payments ar I default, ,
PR - 5 q~i
MOHELA VTAM KD26 TSX20
DATE 091'0411'2 11:52[59 "'PAYOFF CALCULATION TOTALS
BORROWER SSN:
NA~tE : JOSHUA DOMINGUEZ JR
REQUESTED PAYOFF DATE: 09 04 12
TOTAL PAYOFF AMOUNT: 18,251.68
TOTAL PRINCIPAL DUE: 16,540.66
TOTAL INTEREST DUE: 1,486.02
TOTAL PREPAYMENT FEE: 0.00
TOTAL DAILY INTEREST: 2.25
TOTAL PAST~DUE AMOUNT: "+4,629.74
TOTAL LATE FEES DUE: 225.00
TOTAL PENDING SUPP FEES: 0.00
F1=HELP F3=EXIT F4=LETTER, F9=PRT F12=CAN
~~
~f I ~~~~~~ ~~
VERIFICATION
I, Joseph Petri, Manager , Repayment Assistance Department ,
(nemej (title)
of the Higher Education Loan Authority of the State of Missouri aka MOHELA, verify that
the statements made in the aforegoing document are #rue and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa. C. S. §4904, relating
to unsworn falsification to authorities.
Higher Education Loan Authority of the State of
Missouri aka H
By: . ~O,
Josue Petri - V
Title: M Hager, Repayment Assistance Department
Dated: November 26, 2012
38503!92634036
DOMINGUEZ