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Department of Student Financial Services
Sample
Short Term Loan Promissory Note
(please come to the Short Term Loans Office to get this form)
111-11-1111
Student Name
Address
City, State, Zip Code
State University of West Georgia
1600 Maple Street
Short Term Loans
Carrollton, GA 30118
Short Term Loan Promissory Note
Date (mm/dd/yy)
I promise to pay State University of West Georgia SHORT TERM LOAN FUND
$000.00
for value received, with interest of $5.00, payable according to the repayment
schedule and terms below. Should the loan become in default it will be accelerated
and turned over to a collection agency. The borrower will be responsible for
any collection costs, including attorney’s fees and court costs. A late
charge of $5.00 should be included with any payment(s) not made on or before
the original due date(s) as stated in the repayment schedule below. YOU ARE
REQUIRED TO MAKE PAYMENTS ON THE DATE(S) STATED BELOW. THERE WILL BE A $5.00
LATE FEE ASSESSED FOR EACH PAYMENT THAT IS NOT MADE ON THE SCHEDULED DUE DATE.
In addition there will be a 6% interest charge assessed on any outstanding
balance after the last payment date on this promissory note.
Payment 1 in the amount of $0.00
due on mm/dd/yy
Payment 2 in the amount of $0.00 due on mm/dd/yy
Payment 3 in the amount of $0.00 due on mm/dd/yy
Returned check charges will be handled according
to the school-wide policy. By signing this Promissory Note you are certifying
that,"I waive exemption of all kinds under proceedings in Bankruptcy, and
authorize ant trustee in Bankruptcy upon proof and allowance of this debt, to
retain and sell sufficient of the property claimed as exempt to pay off the
amount so allowed on the debt. I further waive demand, protest, and notice of
demand, and non-payment on this debt."
By signing this Promissory Note you are certifying
that "I received a copy of this Promissory Note, and agree to make payment(s)
on the date(s) as stated in the repayment schedule without being billed."
This note is signed as a sealed instrument. Information may be used for collection
purposes.
You must be prepared to repay your Short Term Loan
by cash, credit card, or personal check. If you are expecting a financial aid
balance check State University of West Georgia will not cash the balance check
for you to repay your loan. State University of West Georgia reserves the right
to refuse to accept a personal check if you have been placed on a cash-only
basis for insufficient funds.
Please be aware that Short Term Loans will be reported
to a national credit bureau as a debt incurred. Therefore, payment history will
also be reported. Late payments could have a negative impact on your credit
rating. By signing this Promissory Note, you are certifying that you are aware
of this fact.
It is your responsibility to notify the Short Term Loan office of any changes
in your address or phone number .
This Promissory Note is a legal contract. By signing it you are certifying
that you have read, understand, and agree to its terms and conditions. If you
do not understand anything on this promissory note, please ask before you sign.
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_____________________________
Student Printed Name |
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_____________________________
Witness: Staff Member Signature
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_____________________________
Signature of Maker
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_____________________________
Social Security Number
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_____________________________
Date
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