EDUCATION LOAN PAYMENTS PAID FORM by ptq12475

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									                                           Name of Student Financial Aid Applicant (please print):
Return to:
Office of Financial Aid
301 Platt Boulevard                         Last                 First                Middle
Claremont, CA 91711
Office: (909) 621-8055                      Social Security Number:
Fax: (909) 607-7046
Email: financial_aid@hmc.edu


                  EDUCATION LOAN PAYMENTS PAID FORM
The Harvey Mudd College Office of Financial Aid may consider repayment of Federal student or parent
education loan(s) in the 2009 calendar year (January 1, 2009 through December 31, 2009).

This form must be accompanied by verification of Federal student or parent education loan
payments paid. Acceptable documentation for verification would be documentation of payments and
outstanding balances from the lender. For your convenience, please list payments made in 2009 below
and attach documentation:


      NAME OF LENDER/AGENCY PAID                             DATE PAID                    AMOUNT PAID
                                                                              $
                                                                              $
                                                                              $
                                                                              $
                                                                              $
                                                                              $
                                                                              $
                                                                              $
                                                                              $
                                                          TOTAL PAID IN 2009: $



SIGNATURE(S):


               Father’s Signature                                             Date



               Mother’s Signature                                             Date

								
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