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VMLRP Loan Information Form (NIFA-04-10)

This form requests information on qualified loans you want considered for the VMLRP. Only outstanding educational loans from a legally enforceable institutional, State or Government education loan made for the purpose of meeting the costs of attending an accredited college or university of Veterinary Medicine will be considered. 


If you have qualified loans with different loan servicers, complete this form for each loan servicer. For example, if you have two loans with Sallie Mae and six loans with ECSI, you should complete two Loan Information Forms, one for Sallie Mae and one for ECSI.

Section 1 – Provide the applicant's name, name of the lending institution and account number, name and address of the servicing agency for the loan(s) you wish to be considered for repayment. 

Section 2 – Provide details on your loan including the original loan amount (at time loan was originated), date of loan (mm/dd/yyyy), payoff information (current balance of your loan and the date of the balance), and the current interest rate of your loan. Also, provide details on the current repayment status of your loan. Include the loan type (e.g., Stafford, Perkins, Consolidated, Private, etc.). If you are completing the form for a group of loans, enter the total amount and the earliest date (first loan) where appropriate.

Section 3 – The applicant’s signature in this section provides authorization to lenders and their collection agents to disclose information on the applicant’s loans, including the loans’ repayment status.

Sections 1-3 must be completed prior to the application deadline. DO NOT complete Section 4 as part of the application. If an applicant is recommended for an award, NIFA will ask a representative at the applicable lending institution to complete Section 4.

Section 4 – This section asks your lender to sign to certify the accuracy of the information provided in Sections 1-3 of this form. This section must be completed by an authorized representative of the institution currently servicing the loan(s). The Federal Tax Identification Number (or EIN) is also required prior to the disbursement of the first payment to this lender on behalf of the participant (successful applicant).

Additionally, for each group of loans, you need to provide:

  1. Promissory Note(s)/Disclosure Statement or Equivalent
  2. Lending Institution Account Statement Loan Summary Report
  3. Lending Institution Account Statement Individual Loan Detail Report(s)
  4. Federal Student Aid Loan Summary Report
  5. Federal Student Aid Individual Loan Detail Report(s)

PLEASE NOTE that the VMLRP will only repay debt incurred at an institution that is accredited at the time of attendance and graduation. If an institution received full accreditation status during the participating individual’s attendance at said institution, only the portion of veterinary school loans that were disbursed subsequent to the institution’s date of accreditation shall be repaid by the VMLRP. This includes any scenario involving an individual transferring from a non-accredited institution to an accredited institution. Applicants with a degree from an institution that was not accredited at the time the degree was earned remain ineligible for award. This is regardless of the fact that the applicant may have attended an accredited institution prior to transferring to a non-accredited institution from which they received their D.V.M..

IMPORTANT: Loan Document Tutorial

Please read our Loan Document Tutorial to obtain a better understanding of what is required of you in terms of providing the appropriate supporting loan documentation.

IMPORTANT: Loan Consolidation

If you consolidated your loans, it is important that you visit our Loan Consolidation section to learn more about how a loan consolidation affects your eligibility and award level for the VMLRP.

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