2022 Cardozo LRAP Application 1

LRAP

Laurie M. Tisch Loan Repayment Assistance Program

Cardozo School of Law

Center for Public Service Law * Office of Student Finance
55 Fifth Avenue, New York, NY 10003
Email: cardozolrap@yu.edu

Web: www.cardozo.yu.edu/lrap

*** 2022 APPLICATION 1 ***

Application Information & Instructions

Please complete and submit Parts 1 & 2 of the 2022 LRAP Application.

Part 1

Complete & submit Cardozo's online 2022 LRAP Application 1 (below).

Part 2

Email the the following documentation to: cardozolrap@yu.edu

A copy of your 2021 W-2 and Federal Income Tax Return.
A copy of your 3 most recent pay stubs.
Copies of your student loan billing statements for each educational loan for which you are responsible. The statemetns must include the monthly/quarterly repayment amount & the outstanding loan balance of each educational loan. Please submit the following (where applicable):
- Private loan statements (July 2022 - September 2022)
- Institutional loan statements (3 most recent monthly/quarterly statements)
- Federal loan statements (January 2020, February 2020, March 2020 statements. Please note - we will not be providing LRAP assistance for federal loans while payments and interenst are suspended. We are still requiring the submission of these statments with this application).
Any supporting documentation concerning your resources and/or extraordinary expenses.

If Married:

A copy of your spouse’s 2021 W-2 and Federal Income Tax Return.
A copy of your spouse’s most recent pay stub.

Submit ALL "Part 2" supporting documentation

in one email to: cardozolrap@yu.edu

Email subject line:

"2022 LRAP Application 1 - Part 2"

* * * * *

2022 LRAP Application 1

(Parts 1 & 2)

Submission Deadline: October 19, 2022

Your 2022 LRAP application will NOT be processed if any of the required documentation is not properly submitted.

You are required to furnish the LRAP Committee in writing if there are ANY changes to your employment, income, overall finances, student loan repayment plan(s) and/or $ amount(s), or any other pertinent details, from the date of your 2022 LRAP Application submission until the end of the 2022 LRAP funding cycle.

2022 LRAP APPLICATION 1

PART 1

Section A: Primary Information

Name

First NameLast Name

Graduation Year from Cardozo

YU Banner ID #

SSN (Last 4 Only)

Primary Email

example@example.com

Secondary Email

example@example.com

Cell Phone Number

Area CodePhone Number

Address

Street Address

Apt. #

CityState / Province

Postal / Zip Code

Section B: Employment Information

Employer

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Job Title

Job Description

Employer Type

Public InterestGovernment

Employment Status

Full-TimePart-Time

Initial Date of Employment

Date

Annual Salary $

Annual Overtime $ (if you receive overtime pay, please indicate the total annual amount)

Does your employer provide any program to assist with the repayment of your educational loans?

YesNo

If yes, what is the total annual assistance $?

Supervisor's Name

Supervisor's Job Title

Supervisor's Email

Will you be employed by more than one employer during the 2022 Program year?

YesNo

If yes, please provide the following details (business name, job description, hours per week)

Additional annual income $

Do you plan on voluntarily leaving your current position for a new position by November 2023?

YesNo

If yes, please provide the following details (public or private sector, business name, job description, part or full-time)

If yes, what is the anticipated start date?

If yes, what is your anticipated new salary $?

Section C: LRAP History

2021 LRAP Award $

2020 LRAP Award $

2019 LRAP Award $

2018 LRAP Award $

2017 LRAP Award $

Section D: Student Loan Information

Federal Student Loan

Due to the pandemic, all federal student loan plans have been automatically suspended effective 3/13/20 - 12/31/22. Please be sure to provide your federal student loan details below that reflect your status just prior to the 3/13/20 suspension Only select the forbearance option below if your federal loans were in forbearance prior to the 3/13/20 suspension. Please note that we will not be providing LRAP assistance for federal loans during this round due to the suspension of federal loans through 12/31/22.

Please Note - Should the federal student loan suspension expire on 12/31/22, as currently set by the Department of Education, triggering active repayment and interest on all federal student loans in early 2023, we will open up the 2022 LRAP cycle to include federal student loans. An email notification will sent at that time once we post the additional 2022 LRAP application to our website.

Balance $

Total federal loan balance as of the day you complete this application.

Repayment Plan (prior to the 3/13/20 suspension)

(Ex. IBR, PAYE, REPAYE, Standard, Extended)

Repayment Status (prior to the 3/13/20 suspension)

Monthly Repayment Amount $ (prior to the 3/13/20 suspension)

Income Driven Repayment Annual Reset Date prior to the 3/13/20 suspension (DO NOT LEAVE BLANK!)

Date

Private Student Loan

Balance $

Total private loan balance as of the day you complete this application.

Repayment Status

Active RepaymentForbearanceDefermentDelinquent / Default

Monthly Repayment Amount $

Required monthly repayment amount only!

Institutional Student Loan

Balance $

Total Institutional loan balance as of the day you complete this application.

Repayment Status

Active RepaymentForbearanceDefermentDelinquent / Default

Are your payments due monthly or quarterly?

MonthlyQuarterly

Monthly/Quarterly Repayment Amount $

Required monthly/quarterly repayment amount only!

TOTAL STUDENT LOAN DEBT

Total Student Loan Debt $ (federal, private, & institutional)

Total student loan balance as of the day you complete this application.

Total Monthly Student Loan Payment Amount $ (private and institutional loans only!)

Total required student loan monthly/quarterly repayment amount.

Section E: Spouse Information

If you have a spouse, you are required to have him/her complete the following section and submit the required documentation.

Employed?

YesNo

If unemployed, are you receiving unemployment insurance and/or any severance pay? If so, please provide details ($ amount / dates).

Employer

Job Title

Job Description

Employer Type

Public Sector (Government or Public Interest)Private

Employment Status

Full-TimePart-Time

Initial Date of Employment

Date

Annual Salary $

Supervisor's Name

Supervisor's Job Title

Supervisor's Email

Will you be employed by more than one employer during the 2022 LRAP Program year?

YesNo

If yes, please provide the following details (business name, job description, hours per week)

Additional annual income $

Do you plan on voluntarily leaving your current position by November 2023?

YesNo

If yes, please provide the following details (public or private sector, business name, job description, part or full-time)

If yes, what is the anticipated start date?

If yes, what is your anticipated new salary $?

If you have student loan debt :Does your employer provide any program to assist with the repayment of your educational loans:

YesNo

If yes, what is the total annual assistance: $

SPOUSE STUDENT LOAN INFORMATION

Do you have student loan debt?

YesNo

Student loan type?

FederalPrivateInstitutionalState

Indicate in the table below, the $ amount of your monthly federal loan payment before the Dept. of Ed's suspension was implemented on 3/13/20, and whether you expect your loans will go into active repayment when the suspension is lifted by the Dept. of Ed.

Enter the $ amount in each appropriate box

	Loan Balance $	Monthly Loan Payment $	In Active Repayment (Yes or No)
Federal Loan
Private Loan
Institutional Loan
State Loan
TOTAL LOAN DEBT

Federal Loan Repayment Plan

If you have federal student loans, select the repayment plan you believe you would be enrolled in if not for the pandemic related loan suspension.

The undersigned applicant hereby requests and authorizes the above-named employer and any other past or present employer of the undersigned to verify or otherwise furnish to Benjamin N. Cardozo School of Law of Yeshiva University the “Employment Information": called for in this application form.

Spouse's Name

First NameLast Name

Spouse's Signature

Clear

Date

Section F: Monthly Income and Expenses

Current Monthly INCOME (input $ amount)

	Applicant	Spouse
Gross Income
Overtime / Bonuses
Child Support / Alimony
Trust Fund Income
Rental Income
Capital Income
Unemployment Compensation
Social Security Income
Parental Support
Other Familial Support
Other
TOTAL MONTHLY INCOME

Bank Account - As of the day you complete this application (input $ amount)

	Applicant	Spouse
Checking Account
Savings Account

Current Monthly EXPENSES (input $ amount)

	Applicant	Spouse
Rent
Mortgage
Maintenance
Gas + Electric
Phone
Cable
Internet
Food
Transportation
Health Care
Educational Expenses (non-student loan)
Child Care
Consumer Debt Payments
Car Payments
Student Loan Payments
Other
TOTAL MONTHLY EXPENSES

If expenses are shared by all family members, the expense should be noted in the Applicant column.

Section G: Other LRAPs

Applicants are encouraged to take advantage of any other LRAP programs (such as state, federal, or employer LRAPs). Application and receipt of other LRAPs will be considered by Cardozo’s LRAP Committee, but will not necessarily disqualify an applicant.

For the previous year, please identify any LRAP programs for which you applied and received funding:

	Name / Source of LRAP	Amount Awarded $	Date Awarded
Other LRAP
Other LRAP
Other LRAP

2022 LRAP APPLICATION 1

VERIFICATION & SUBMISSION

VERIFICATION

Please confirm that you have reviewed and completed ALL of the required sections in the 2022 LRAP Application 1 (Part 1).

Please confirm that you have gathered all of the required documentation for the 2022 LRAP Application 1 (Part 2) and that you are emailing ALL of the them by the October 19, 2022 deadline, in one email to: cardozolrap@yu.edu.

I hereby certify that the information on this form is true and complete to the best of my knowledge. I agree to notify Cardozo’s LRAP Committee of any changes in the information reported in Parts 1 & 2 of the 2021 LRAP Application 1, from the date of submission until the end of the 2021 LRAP cycle. I understand that I may be asked to provide documentation of information provided here. I affirm that funds provided to me through Cardozo’s LRAP will be used solely for my student loan repayment.

Applicant's Name

First NameLast Name

Applicant's Signature

Clear

Date

SUBMISSION

To officially submit your 2022 LRAP Application 1 (Part 1), please click the *SUBMIT* button below.

If you have any questions, please email cardozolrap@yu.edu.

Thank you for applying!

Laurie M. Tisch Loan Repayment Assistance Program
Cardozo School of Law
Center for Public Service Law * Office of Student Finance
55 Fifth Avenue, New York, NY 10003
Email: cardozolrap@yu.edu
Web: www.cardozo.yu.edu/lrap