Print Form
5200 N. Lake Road
Merced, CA 95343
Phone 209-228-7178
Fax 209-228-7861
E-mail: [email protected]
Clear Form
URL: http://financialaid.ucmerced.edu/
2016-2017 ADJUSTMENT TO STUDENT LOANS
Student UCM ID
Student Full Name
First Name
Last Name
M.I.
ONLY return this form to the UCM Office of Financial Aid & Scholarships if:
a. You wish to decline student loan(s) or you wish to REDUCE the loan(s) you have already been awarded (Loan Adjustment Section) or
b. You wish to request, reinstate or increase a student loan (Loan Adjustment Section) or
c. You will NOT attend UCM for all, or part, of the 2016‐17 Academic Year (Term Adjustment Section)
Term Adjustment Section
1.
I will NOT be attending for one or more semesters during the 2016‐17 Academic Year. Please indicate the semesters.
Fall 2016
Spring 2017
Full-Year 2016-17
Loan Adjustment Section
2.
Please indicate in the appropriate area below that you wish to decline aid, request aid or reduce/increase aid.
Check the appropriate box
Loan Type
Decline*1
Reinstate2
Increase3
Decrease **4
Enter the amount, new total and/or term
Amount5
New total
Term(s)6
Direct Subsidized Loan
Direct Unsubsidized Loan
Direct Grad PLUS Loan
DREAM Loan
Alternative Loan
NOTE: *Requests to decrease a previously disbursed Direct Loan must be made within 90 days of the same Direct Loan being credited to your UC Merced Account.
**DECREASING a previously disbursed Direct Loan may result in a balance owed on your UC Merced Account. Balances that remain unpaid may result in adverse consequences
including (but not limited to) late fees, holds on registration, transcripts, etc....
Student Explanation
STUDENT CERTIFICATION
I have completely read this form and I understand that I am responsible for any balance owed resulting from my Direct Loan Adjustment request. I
understand that non-payment of a balance owed may result in late fees and a hold put on my account for any transcripts, registration, etc.... I hereby
declare that all information reported on this document is true, complete, and accurate to the best of my knowledge. I understand that any false
statement or misrepresentation will be cause for denial, reduction, withdrawal, and/or repayment of financial aid and referral to the appropriate
authorities. I understand that even if I make a request to have my loans adjusted the financial aid office may not be able to process due to federal
regulations/limits.
Student Signature
Date
1 Check the box for the specific loan(s) you want to Decline.
2 Check the box for the specific loan(s) you would like to Request/Reinstate and indicate the corresponding loan amount in the Amount box. Enter the word
“Max” to receive the maximum eligible amount.
3 Check the box for the specific loan(s) you would like to Increase and indicate the corresponding loan amount in the Amount box. Enter the word “Max” to
receive the maximum eligible amount.
4 Check the box for the specific loan(s) you would like to Decrease and indicate the corresponding loan amount in the Amount box. Please note that the
minimum eligible amount is $200.
5 Enter the Amount for the specific loan(s) you want or enter the word “Max” for the maximum eligible amount.
6 All award amounts are distributed evenly among the terms of enrollment for the academic year. If you are requesting a loan for a specific term(s), please
ADJL2/3_1617
indicate the term(s).
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RV 1/26/2016