SLM Financial Corporation a Sallie Mae company K-12 Loan Application Sales Rep:

Fax Applications to: 1-856-596-3594 Call With Questions: 1-877-834-9851

Mail Applications To: SLM Financial Corporation PO Box 470 Marlton, NJ 08053-0470

Instructions: If all information is not completed in full, the processing of your application may be delayed. Initial any changes; do not use correction fluid Please fill in School Information to assist us in our school verification process. By submitting this application, you authorize SLM Financial to check your credit history whether or not your application is signed.

Section A: Borrower Section:

Please complete all information in this section

Loan Amount Requested: $

Requested Disbursement Date:

Repayment Term Requested (years):

Full  Name:

Last

First

MI

Jr. / Sr.

Social Security Number

Date of Birth (month/day/year)

Street Address

Apt #

Rural Route

Own

Rent

Live With Parents

City

State

Zip Code

How Long at Current Address Years Months

Home Phone ( )

Mailing Address if different from Street Address above

Landlord / Mortgage Holder Name & Phone #

Monthly Mortgage / Rent Amount $

Approximate Balance (Mortgage only) $

Approximate Home Value (If you own) $

Work Phone ( )

Employer Name

Position / Title

How Long Years Months

Other Income Source: $__________________

Employer Address

State

Zip Code

Gross Annual Salary $

Note: You should include income of your spouse or any person in your household who is jointly responsible with you for debts .You do not have to reveal alimony, child support or maintenance income unless you wish it to be considered as a basis for loan repayment.

Reference Name (Do not use co-borrower.)

Reference’s Permanent Address:

Reference’s Home Phone

Relationship

Reference Name (Do not use co-borrower.)

Reference’s Permanent Address:

Reference’s Home Phone

Relationship

Reference Name (Do not use co-borrower.)

Reference’s Permanent Address:

Reference’s Home Phone

Relationship

Section B: Co – Borrower Section

Please complete all information in this section if applying jointly.

Relationship to Applicant:

Social Security Number

Full  Name:

Last

First

MI

Jr. / Sr.

Home Phone ( )

Date of Birth (month/day/year)

Street Address

Apt #

Rural Route

Own

Rent

Live With Parents

City

State

Zip Code

Work Phone ( )

Monthly Mortgage / Rent Amount $

Approximate Balance (Mortgage only) $

Approximate Home Value (If you own) $

How Long at Current Address Years Months

Employer Name

Position / Title

How Long Years Months

Other Income Source: $__________________

Employer Address

State

Zip Code

Gross Annual Salary $

Note: You should include income of your spouse or any person in your household who is jointly responsible with you for debts .You do not have to reveal alimony, child support or maintenance income unless you wish it to be considered as a basis for loan repayment.

Section C: Student/School Section:

Please complete all information for each student. Please Aid us by completing School information to the best of your knowledge.

School Code: 4350

School Name Safe Harbor Academy

School Address  4472 Safe Harbor Way  Jacksonville, FL  32226

School Contact: Robbie W. Smith

School Phone (904)757-7918

Last First MI First  Student

Social Security Number

Tuition $

Grade Level

Relation to Applicant

This application will be submitted to SLM Financial Corporation for approval. I/we authorize SLM Financial Corporation to make whatever credit inquiries it deems necessary in connection with this loan application and in the course of review or collection of any credit extended in reliance on this application. I/we authorize and instruct any person or consumer reporting agency to furnish to SLM Financial Corporation any information that it may have or obtain in response to such credit inquiries and agree that such information, along with this application, shall remain SLM Financial Corporation’s property, whether or not a loan is approved. All information set forth in this application is declared to be a true representation as to the facts, made for the purposes of obtaining the loan requested, and any willful misrepresentation in this application may result in criminal action. Sallie Mae and its affiliates may share credit and other information about you with each other for marketing and administrative purposes. If you do not want credit information about you from your application, consumer reporting agencies, or third parties shared with our affiliates, you will need to send us a signed letter telling us so with this application.
 

________________________________________________________ _____________
Borrower’s Signature Date

_______________________________________________________ _______________
 Co- Borrower’s Signature Date

Copyright 6/2000 SLM Financial-K12

The loan application should be completed by typing or printing in black ink. If you need to make corrections, cross out the wrong information, write in the correct information, and be sure to initial your corrections. Do not use correction fluid.

APPLICANT:

      #  Complete the Applicant sections on the application (Sections A & B)
      #  Complete Section C completely including School Information
      #  Sign bottom of application (and Co-Borrower sign if applicable)

* Application must be Completely filled out to process