# U.S. Department of Education’s

Student Aid Internet Gateway

Application For

State Grant AgenciesO MB NO : 1 845

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## Student Aid Internet Gate w ay Application for State Grant Agencies

Introduction

The Student Aid Internet Gateway (SAI G) was estab l ished to allow autho r ized entities, including State Grant

Agencies (the Agenc y ) to exchange data electronically with the U.S. Department of Educat i on (ED, Department )

. In order t o participate in the SAIG, e a ch entity m u st en roll for SAIG ac c es s

. T h e SAIG Application for St a te Grant

Agencies is co m

p rised of two parts, an SAIG Enrollment F o rm and the SAIG Participation Agreement for State

Grant Agenc i es.

1

. Part One

- SAIG E n rollment Fo r m fo r State Grant Agencies (pages 8

– 15), which is c o mp rised of

four sections: Section One

– In formation about the State Grant Agenc ies

- Instructions , including a

description of whether the form is being used for an initial application, adding a new Primary Destination

Point Administrator (Primary DPA) or Non

- Primary Destination Point Administrator ( Non

- Pri m ary DPA )

,

or changing infor m ation about t h e Primary DPA or N on

- Pri m ary DPA; Section Two

– Tell us about the

services for which the Primary DPA want s to enroll for the DPA in Section One

– this is where the DPA

identified in Section One is enrolling in SAIG services; Section Three

– Responsib i lities of the Primary

and Non

- Primary D estination P oint A dministrator ; Section Four

– Certif i cation of the President/CEO or

Designee; a n d Section Five

- Federal S t udent Aid User of Electronic Services S t at e ment.

2

. Part Two

- SAIG Part i cipation Agreement for Sta t e Grant Age n cies (pages 1 6

– 2 4 ), is the legally

bindi n g agreement between the Department and the Agenc y

. The SAIG Particip a tion Agreem en t establishes

t h e con ditions under which t h e Department will provide t he Agency with certain data received or generated

by the Department concer n ing applicants for the Title IV, HEA student financial aid programs (FAFSA Applicants)

. In addition, the SAIG Participation Agreemen t provid e s the authority for the agr e e m ent, as we l l as,

authorized uses and disclosures of data, data security, and reporting of unauthorized disclosures.

Information about the Enrollment Pr o cess to Part i cipate in the U.S. Depar t ment of Ed u cation’s SA I G

The enroll m ent process will enable the Age n cy to select services to receive, and/or view, student financial aid data

either online or by batch process i ng using ED provided software

- EDconnect (PC

- based sof t ware) or TDClient

(client software for m

u ltip l e environ m e n ts).

Each Agency m

u st d e signate one individual as its P r imary Destination Po i n t Administrator (Pr i m ary DPA )

. Each

Agency is also pro v ided w i th a Primary Destinat i on Point (an SA I G m ailbox, which is identi f ied b y a TG Number )

. The Primary DPA is the on l y person w i thin the Agency who m ay enroll other agency staff as Non

- Primary DPAs

with Destination Po i n ts assigned for sp e cific SAIG services. Upon co m p leting the enroll m ent process, the Pr i m ary

DPA can add or re m ove users, edit information about the Agenc y

, o r change the Agency’s en r o ll m ent in various

SAIG services.

To m aintain a cce s s to Federal Student Aid s y st e m s, the Pr i m ary DPA m u st validate the individuals enrolled for a

SAIG Mailbox and Electronic Servic e s for the Agency on a schedule dete r m i ned by ED. If validation is not

c o m p leted via the SAIG En roll m ent W e b site within the prescribed timefr a me, a l l services a ss i gned to the Agency

and the Agency ’ s individuals could be deactivated.

Notes about the SAIG A p plication

–

The first usage of a te r m in this docu me n t is it a licized and can be found i n the g l ossary located in

Attac h ment A. The glossary will assist in understanding the many technical te r m s and acr o n y m s

c o m m only u s ed in the Title IV, HEA student financial aid programs and in connection w ith the

SAIG s y st e m

.O MB NO : 1 845

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E ffectiv e Date : Janua ry 2014 Stat e G r an t Agenc y Fo r m Pa g e 3 Available Services for S t ate Grant Ag encies

The services th at a State G r ant Agency c an acc e ss ov e r the SAIG a r e:

 Automatic I S IR processing: A State Gr an t Agency can receive proces s ed Free Application for Federal Student

Aid (FAFSA) applicant data in the form of an Institutional S t udent I n formation R ecord (ISIR) from the

Department’s Central Processing System (CPS)

. An Agency m ay receive data fo r Residents (Title IV applicants

who indicate on their FAFSA, as their state of l e gal residence, the sta t e w h ere the Ag ency is located) and /or

Non

- Residents (Title IV applicants who included on their F AF SA a post

- seconda r y i n s titution that is i n the state

where the Agency is l o cated )

. With this service, ISIRs are au to matically trans m itted to the State Grant Agency

when students submit FAFSA a pplications and c o rrections to ED. The I SIR contains infor m ation sub m itted by

the stude nt, a s well as CPS processing results. The DPA is aut o m a tically enroll e d for Fi n anc i a l Aid

Administrator (FAA) Access to CPS Online and EDconnect as part of enrolling for ISIR processing. Only one

person at the Agency c an be enr o lled in the Automatic ISIR P r ocessing.

 National St ud ent Loan Da t a Systems (NSLDS) Online: View Onl y : The Agency m ay request that a DPA have

online access to NSLDS to view Title IV, H E A loan, grant, and enrollment history.O MB NO : 1 845

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E ffectiv e Date : Janua ry 2014 Stat e G r an t Agenc y Fo r m Pa g e 4 Agency Per s onnel Involved in the SAIG Enrol l m e nt Application Process

There are four categories of users at the Agency who may obtain data fr o m the Depar t ment ’ s s y ste m s and who m u st

c o m p lete par t s of the SAIG Application:

 President /C EO or D e signee: The President/CEO is the indiv i dual responsible for identi f y i ng a Pri m ary

DPA for the Agenc y

, and who is legally authorized to execute the SAIG Partic i p ation Agreement in Part

Two on beha l f of the Age n c y

. T h is person is also r esponsible for s igning the E n rollment Form in Section

Four

- Certification of the President/CEO or Desi gnee on behalf of the State Gr an t Agency and to authorize

the enroll m e n t for the Primary DPA or N on

- Pri m ary D P A. The President/CEO may also assign a Designee

in Section Four to act as the Authorizing Official on behalf of the President/CEO for future en r o l l m ents;

however, only the President/CEO is authorized to sign the S A IG Participation Agree ment in Part Two.

 Primary D es tination Point Adminis t rators (Prima r y DPA): T h e Pr i m ary DPA i s th e individua l a t the

A g e n c y w h o i s responsible for the ad m i n istratio n of t h e Agency’s SAIG participation which in cludes

assigning ac c ess to the Agency ’ s m ail b oxes and services and de t e r m i nin g the Ag e n c y’ s El e c t ronic Servic e s

Use r s. The Pr i m ary DPA is the on l y individual with i n the Agency who m ay enroll A g e n c y staff as Non

Pr i m ary DPAs. The Prim a ry DPA is required to co m plete and submit Sections One thro u gh T h ree of the

SAIG Enrollment Application to the Coralville, Iowa address provided. When e n rolling Non

- Pr i m ary

DPAs, a portion of Section Three of the Enroll m ent Fo rm m u s t be c o m

p leted by the Primary DPA

indicating th a t the Pri m ary DPA has rev i ewed the res p onsibilities of DPAs with the Non

- Primary DPA,

including the responsibili t y to protect the privacy of the information obtained or provided via SAIG. The

Pri m ary DPA is a lso responsible for ob t aining the si gn ature of the President/CEO or Designee in Section

Four for every enroll m ent of a Primary or Non

- Pri m a ry DPA.

 Non

- Prima r y Destination Point Administrators ( Non

- Prima r y DPA ) : When a Pr i m a ry DPA enrolls a

Non

- Pr i m ary DPA i n t

h e S AIG

, ED will assign the Non

- Pri m ary DPA a S AI G Ma il bo x w i t h a u n i q u e T G

nu m b er

. The Non

- Primary DPA, in collaboration with the Primary DPA, is required to co m p lete and

sub m it Sections One through Three of t h e Enroll m e n t Application.

 El e ct r oni c Se r v i c e s U s er s : Electronic Services U sers are enrolled for FAA Ac ce ss to CPS Online or

EDconnect by the Pri m ary DPA. These Users are a sso ciated with the Primary Destination Po i n t and do not

require indiv i dual l y assigned mailboxes to access FAA A c cess or EDconnect. To protect the integri t y and

security of the data being trans m itted, a l l Electronic S e rvices Users m u st c o m p lete and sub m

it Section Fi ve

– Federal Student Aid User of Electronic Services S t at e ment to their Pr i m ary DPA. Section Five m u st a ls o be

signed by and m aintai n ed by the Primary DPA at the Agenc y

. Section Five User Sta te m en ts m u st be

available for inspection by the Depar t m e nt.O MB NO : 1 845

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## Part O n e: SAIG E n rollment Form for State Grant Agencies

- Instructions

Completing the SAIG E n rollment Fo r m

Gen e ral R e minder:

The SAIG Enrollment Form may be co m pl eted online at https://fsawebenroll.ed.go v

. As an alternative, the

enrollment fo r m can be print ed on paper, co m p le t ed, and sub m

itted to the address on page 7 of these instructions.

Please note that the Departme n t will not accept phot o copied signatures or s t amped signatures. Forms

submitted after the Office of Manag e ment and B u dget (OMB) Expiration D ate noted on the bottom of each

page will not be accepted.

Help and Q u estions on Completing and Submitting the Enrollment Form

If you have a n y q u estions about co m p leting the SA I G Enroll m ent For m

, call CPS/SAIG Technical Sup p o r t at

1

- 800

- 3 30

- 59 4 7

. To re a ch a telec o m m unications device for the deaf (TDD/TTY), CALL 1

- 800

- 5 11

- 580 6

. Technical support representatives are available 7 A.M.

– 7 P.M. Central Time

, Mond a y th r ough Frid a y

, excluding

federal holid a y s. If y ou prefer, y o u can e

- m ail inquiries t o C PSSAIG@ed.gov

. A technical support specialist will

respond to y o ur e

- ma i l within one business da y

.

Section One (Gen e ral Information)

– must be c o mpleted by the Primary D P A for all DPAs

Section One collects information about the t y pe of e n rollment, as well as information about the Agency a nd the

DPA y o u want to enro l l or for whom y o u are changing or add i ng in formation.

Item 1. This SAIG Enroll m ent Form can be used for m u ltiple purposes. A s the Pr i m ary DPA, y o u m a y use the

form to enroll new participan ts in the S AIG and y o u can also use th e form to c h ange or add infor m ation

about an exis t ing DPA or Destination Point.

A. Check Box A for “Initial application” if the Agency is a first

- time SA I G pa r ticipant and the Agency does

no t h a v e a Desti n ati o n P o in t. Th e President/CE O o f t h e Agen cy w il l b e des i gn a tin g t h e ind i vidua l who

wil l serv e a s th e Agen c y ’ s Pri m ar y D P A

. Thi s en r oll m en t wil l establis h thi s u s e r a s th e P ri mar y DP A of

th e Pri m ar y Destinatio n P o in t fo r t h e A g en c y

.

B. Check Box B for “Add i ng a new u ser for an addit i onal Destination Po i n t” if t h e Agency is currently

enrolled in the SAIG and you want to add a Non

- Primary DPA and an ad d itional Destination Point.

F ill in the Primary TG N u m b er f o r the Destina t ion Point.

C. Check Box C for “Changing info r m ation for an e x i s ting Destination Po i n t” if the Agency is currently

enrolled in t h e SAIG and you want to c h ange or add a n y in f o r m ati o n about an existing user or Destination

Point. F i ll in the TG N u m b er for the Destination Poi n t. Also, co m p lete the inform ation that has changed

for a n y ite m s in Sections One and Two; a nd co m p lete Sections Three and Four.

If you are uncertain of which box to c heck, call CPS/SAIG Technical Sup p o r t at 1

- 800

- 330

- 5947. T o

reach a teleco mm unications device for t h e deaf (TDD/TTY), call 1

- 8 0 0

- 5 1 1

- 580 6

.

Item 2. Provide the n a m

e of the Agenc y

, as you would like it to appear on all SAIG correspondence. (The li m it is 40

characters, including letters and spac e s.)

Item 3. This item is pre

- filled with “ State Grant Agency ”.O MB NO : 1 845

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E ffectiv e Date : Janua ry 2014 Stat e G r an t Agenc y Fo r m Pa g e 6 Item 4. Check whether the information being p r ovid e d is for the Primary DPA (only one Primary DPA per

Agenc y ) or for a Non

- Primary DPA (the Agency m ay have m o re than one N o n

- Primary DPA enroll for

NSLDS Online service). A separa t e fo r m m u st be used for each Non

- Primary DPA enrolling for NSLDS

Online service. All information m u st be prov i ded for the DPA enrolling for the Age n cy identified in Item

2. Note: Do not use a group e

- mail address.

Section Two (Selection of Services)

– must be c o mpl e ted by the Primary D P A when adding or changing

servic e s

Section Two allows y o u to add or change servic e s for the Agency a nd the Pri m a r y DPA or Non

- Primary DPA

identified in Section One.

It e m 5. A. If the Agency would like the DPA identified in Item 4 to have acce s s to receive I SIRs

, check e ither or

both boxes f

o r the appropr i ate Aut o m atic ISIR Processing.

B. Check either or both boxes for the awa r d years this DPA should r eceive the a p plicant data. If the

2013

- 2014 award y ear is selected then the Agency w i ll on l y receive 2013

- 14 IS I Rs. If the 2014

- 2015

award y ear is selec t ed the Agency’s en r o ll m ent will be rolled over auto m at i cal l y to inc l ude subsequent

award y ears.

C. Choose t h e preferred delivery opt i on, Daily or B y Request. Daily is the default ISIR delivery m ethod.

If “By Requ e st” is checke d

, the DPA m u st use FAA A cce s s to CPS Online to request and rece i ve ISIRs.

The ISIRs are then sent to the DPA’s SAIG Mailbox th ro ugh t h e SAIG.

Item 6. If you would like NSLDS Online access to view Title IV, HEA loan, grant, and enrollment hi story, check

the ‘Yes’ box, check the ‘NSLDS Online

- View On ly ’ box, specify the state that the Agency is located, and

select all applicable job functions.

Section Three (Primary DPA & Non

- Primary D P A Responsi b ilities)

– must be completed by all Pr im ary a nd

Non

- Prima r y DPAs

Section Three collects the required agreements and sign a ture pages from the Pr i mary DPA or the Non

- Primary

DPA identified in Section One.

Each Pri m ary and Non

- Pr i mary DPA must read and s i gn the “Responsibilities of the Primary and Non

- Pr i mary

D estination Point Ad m inistrators” sta te ment.

Section Four

– must be completed by t he Agency President / C E O or Design e e

Section Four collects the r e quired authorization from th e Agency to process the en r o ll m ent information for the

Pr i m ary DPA or N on

- Primary DPA identified in Section One.

If the President/CEO wishes to designate another person to be t h e responsible authorizing of f icial (the Designee),

then Section Four, Box 1 m u st be c o mpleted. This designation needs to be co mpleted only once.

For each Des t ination Point, the President/CEO or Des i g n ee m u st sign the Certification of the President/CEO or

Designee on behalf of the State Grant Ag ency in Section Four, Box 2.O MB NO : 1 845

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E ffectiv e Date : Janua ry 2014 Stat e G r an t Agenc y Fo r m Pa g e 7 Submitting Enrollment Form and Signature Pages

Send y o ur co m

pl eted SA I G State Grant Agency enroll m ent form and or i g inal, s i gned signatu r e pages to:



## CPS/SAIG Technical Support

2450 Oakdale Blvd.

Coralville, Io w a 52241

Before mailing signature pages, confirm the following:

 The President/CEO or Des i gnee n a me a n d signature m a tch the info r mation on fi l e with the Depar t m ent.

 Signature pa g es for both S e ction Three: Responsibilit i es of the Primary and Non

- Primary Des t ination

Point Admin i strators and Section Four: Certifica tion of the President/CEO or Designee are en close d

.  All signatures are original. Signatures are not p h otoc o p ied or sta m p ed.

O n ce t h e Depart m e n t receives all necessary signature documents, th e De p a r t m e n t will process t

h e enroll m ent.O MB NO : 1 845

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## Part O n e: SAIG E n r ollment F o rm for State Grant Agenc i es

Section On e: Provide the foll o w ing information

1



### . Is t h is an i n itial a pp lication o r are y o u ad d ing a n e w D P A or c h an g ing i n for m a t i o n o n a Desti n ati o n P o i n t ?

Check the a pplicable box below.

A.  I n itial a pp lication

B.  A d d i ng a n e w use r f o r a n a d d iti ona l Des t i n a t i o n Po i n t un d e r P r i m ar y TG

_

C.  C h a ng i n g infor m a t i o n f o r an e x is t i n g D esti n ation P o i n t w ith TG_

(Read i n structions on p a ge 5 carefully.)

2

. Wh at is t h e n a me o f y o ur A ge n c y ?

(ma x imum 40 charact er s )

3

. C o nf i r m y ou r ty p e of o r gan i z ati on.

 State Grant Ag e n cy

4

. C o m p lete t h e f

o ll ow i n g informati o n f

o r t h e Pri m ary o r N o n

- Pri m ary D esti n ati o n P o i n t A d m i n istrat o r ( D P A )

y o u w ish to d e si gn ate at t h e Ag e n cy for t h i s enr o ll m e n t. T h e D P A w ill be a ssig n ed a Desti n ati o n P o i nt w ith

an i d e n tification nu m

b er (TG nu m

b er).

Check one:

 P r i m a r y D PA  No n

- Pr i m ar y D P A

Fi r s t N a m e Last N a m e

B u si n e ss add r ess

B u si n e ss add r ess

City

_ S t ate

_ Zip

Ar ea co d e /pho n e ( _) A r ea c o d e/fax ( )

E m a il Ad d r ess:

(ma x imum 70 character s )

S o cial Sec ur ity N u m

b er D ate o f b i r t h _19_

(month) (d a y ) ( y

e ar)

M o t h er ’ s m ai d en n a m e



### Go to Section T w o

Offi c e Use On l y

Customer Num b er

TG NumberOM B NO : 1845

- 0002

E x pi ra tio n Date : 1/31/2 0 17

E ffectiv e Date : Januar y 2 014 Stat e Gran t Agenc y Form Pa g e 9 

## Section Two: Tell us about the services f o r w hich the Primary DP A wants to enroll for

the DPA i n Section One

5



### . A

. Do you want t h is DPA to h a ve access to ISIR service s ?

 Y e s  No, Go t o Item 6

If ye s

, select the a p propriate s ervice(s):

 Au t o m atic ISIR Process i ng: Resid e nts

 Au t o m atic ISIR P r ocess i n g : Non

- Res i d e nts

B. For w h i c h a w a r d year s ? (Ch e ck one or b o t h

. )

 2 0 1 3

- 20 1 4 o n ly  2 0 1 4

- 20 1 5 and all s ub s equ e nt ye ars

C. C h o o se d eli v ery op tio n :

2 01 3

- 2 0 14  Daily  By Requ e st

2 01 4

- 2 0 15  Daily  By Requ e st

6



### . Do you want t h is DPA to h a ve access to NSLDS Onlin e ? (Note: Paper e nrollment for this se r v ice is not

a v a il a ble. Y ou must enr o ll o nline a t http s : //fsaw eb e nro l l.ed.gov .)

 Y e s  No

IMP O RTA N T: O n ly t h e D P A is p e r m i tted to u se h is or h er D esti n ation Poi n t f o r o n li n e access to N S LDS.

Per m ission to use t h is D e stination Point for online NSLDS access C A NNOT be gr a n ted to an y one else.

 N SL D S O n li n e

- V iew O n ly

S p eci f y State

Indicate your job functions ( c heck all that a p ply):

 1 0 0 % of j ob res p o n s i b ilities related to State Sch o lars h ip and Gr a n t Ag e n cy fu n ctio n s

 Less t h an 1 0 0% of j ob res p o n si b ilities related to State Sch o lars h ip and Gra n t A g e n cy fu n cti o ns

 D efa u lt/ Ov e rpa y m e n t Stat u s

 E n r o ll m e n t

 L o a n F o r g i v en ess

 O t h e r

 C o mme n t s



### Go to Section Three

Offi c e Use On l y

Customer Num b er

TG Number

## Section Three: Re s p onsibilities of the P r imary and Non

- Pr i mary Destination Point

OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

E ffectiv e Date : Januar y 2 014 St at e Gran t Agenc y Form Pa g e 10 

## Administrators

Each Dest i nation P o int Administrator (DPA) m ust r e a d, sign, and s ubmit t h is st atement (with original signatures) and

must keep a c o py for the Agency’s re c ord s

.

1

. Resp o nsibilit i es of the Prim a ry DPA and the Non

- Prim a ry DPA:

 Must en su re that SAIG co m puting re so urces a r e us e d only f o r o f ficial g ov ern m ent b u sin e ss.

 Must en su re that the FAFSA applicant is a r e s i d e nt of the state wh er e the Ag e n cy i s located or h a s includ e d o n t h e

F A F SA a po stseco nd a ry i n stit u ti o n t h at is l o cated i n the state w h ere t h e A g e n cy is l o cate d

.

 O n ly t h e DPA listed in Section O n e, Item 4

, p a g e 8 is p er m i tted to s i g n up a n d use t h e Nati on al Stu d e n t L o an Data

S y stem (NS LD S) as i n dicated in Item 6, page 9.

 M u st u se s o ftware p r ov i d ed by t h e De p a rtme n t to m on itor SAIG m ail bo x acti v ity. T h is s o f t ware will k e ep track o f

who is us i n g the SAIG Mailbox, what i n formation is be i n g access e d, the d a te a n d ti m e of access, and t h e batch

nu m ber (if app licable).

 By applying for access to Federal Stud e n t A i d syste m s, m u st consent t o m onitor i ng, re co rding, an d a udi t ing; a n d

ack no wle d g e t h at i n f

o r m ati o n obtain e d u n d er t h is co ns e n t m ay be discl o s ed by t h e D e p a rt m ent to an ap p ro p riate

t h ird

- p a rty (e.g., law enf

o rceme n t p erso nn e l ).

 Must en su re that all Federal Stud e nt A i d a p plicant inf o r m ation is protect e d from access by or disclo s u re to

un a u tho rized person n el. In the e v e n t of an u n a u t h orized d is closure or an a ctual or s u s p e c ted brea c h of a pplicant

i n f o r m ati o n or o t h e r se n siti v e i n f o r m ati o n (s u ch as p erso n ally i d e n tifia b le i n f o r m ati on ), t h e DPA m

u st n o tify Fe d eral

Stud e nt Aid w i t h in 1 h ou r of bec o m ing a wa r e o f t h e b rea c h at CPS S AIG@ed.go v

.

 Must en su re that pas s word sh aring, t h e s h ar i n g of system access, a n d the use of any t oo l s that allow a c cess to t h e

SA I G a re s t

rictly p r oh i bited. ( These t ools are called “ a uth en ticators.”)

 Must en su re that access is provid e d only to sy st e m s, netwo r ks, data, control infor m ation, and s o ftw a re for which the

D P A is a u t h or i zed.

 M u st e n sure that p r o ce d ures f o r sa n itizing s t o red i n f

o r m at io n are f

o ll o wed (e. g ., o v erwriti n g electr on ic me d ia t h at

c on tain se n siti v e inf

o r m ati o n b e fore re u se).

 T h e N o n

- Primary DPA m u st i n f o rm t h e A g e n c y ’s Pri m ary D P A wh e n ac c ess to a F e der a l Stud e nt Aid sy stem is no

l o n g er re qu i red (i.e. t h e i nd i v i du al is lea v ing a p o siti o n or h is or h er job res p o n s i b ilities h a v e c h an g e d )

.

 T h e i n f

o r m ati o n p r o v i d ed to t h e Pri m ary a n d N o n

- Pri m a ry D P A by t h e U

. S. Dep a rt m ent of E d ucati o n is p rotected by

t h e Pri v acy Act o f 19 7 4, as ame nd ed. Pr o tecti n g t h is i n formati on

, o n ce it is e n tr u sted to t h e Pri m ary a n d No n

Pri m ary DPA, b ec o m es h is o r h e r respo n si b i lity. T h ere f ore, t h e Pri m ary a n d No n

- Pri m ar y DPA m u st p r o tect t h e

pr i v acy o f all i n f

o r m ation t h a t has be e n p r o v i d ed by t h e U. S. Dep a rt m ent of E d ucati o n. The Pri m ary and No n

Pri m ary DPA u n d e rstand t h at a n y p erso n

, i n cl ud ing h i m se l f o r h e rself, who k nowin g ly a n d willf u lly re qu e sts or

ob tains a n y rec o rd co n cer n ing an i nd i v id u al fr o m an a g e n cy u n d e r false prete n ses s h all b e gu ilty of a m is d e m ea no r

a n d is s u b j ect t o a fi n e of u p to $ 5 ,000 (5 U.S.C. 5 5 2 a (i) ( 3)).

2. Addit i onal R e quirements of the Prima r y DPA:

 Must en su re that all users are aware of a n d are in c o m p lia n ce with all o f t h e req u ire m e n ts to p r o tect a n d secure d ata

f r om Depart m e ntal s o urc e s u s ing S A I G

.

 M u st m ai n tain c op ies of all SAIG e n r o ll m e n t do c u m e n ts su b m i tted to t h e De p a rt m e n t, i n cl ud ing t h e s i g n ed

“Res p o n s i b ilit i es of t h e Pri m a ry an d N o n

- Primary Desti n ati o n P o i n t A d m in istrators” form f o r all DPA’s and t h e

certification s i gn e d by t h e Ag enc y ’s Pres i d e n t/CEO or De s ignee.

 M u st m ai n tain a si g n ed F e de r al Stud e nt Aid User o f Elec t ronic S e rvices Stat e m ent (see S ection F i ve) fo r a n yo n e w h o

is enrolled i n E lectronic Serv i ces (FAA Ac c ess to C PS On l ine o r E D c o nn ect).

 At least on a n annual basis, m u st validate all DPA and us e r access rights for the Ag e n cy.

 At least on a n annual basis, m u st m onitor t h e Ag e n cy’s NSLDS user ac c ess by c reati ng r e ports using t h e NS L DS

Web site.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

E ffectiv e Date : Januar y 2 014 St at e Gran t Agenc y Form Pa g e 11 

## Section Three: Re s p onsibilities of the P r imary and Non

- Pr i mary Destination Point

Administrators ( Continue d )

 Must en su re that the Ag e n cy has a pro ce ss t o inform the Pri m ary DPA of any ch an ges i n a user’s need for access t o

Fed e ral Stud en t Aid syst e m s because of c h a ng e s to job r e spons i bilities or ter m ination of e m

ploy m ent. The Pri m ary

DPA m u st immediately deactivate or delete us e r access r i g h ts for Ag e n cy e m ployees who no long e r require acce s s.

3

. Agre e ments

The Pri m ary DPA an d/ o r the N o n

- Pri m ary D P A a g re e (s) and un d ersta n d(s) t h at i n te n tio n al s ub m iss i on o f false o r

m isleading i nf

o r m ation to t h e U

. S. D e part m ent o f Ed ucati o n is su bject t o a fine o f up to $ 1 0 ,0 0 0

, i m prison m ent f

o r u p to

fi v e years, o r b o t h , un d er provisi on s of t h e U n ited States C r i m i n al C od e (i n clu d ing 1 8 U.S.C. 1 00 1 ). T h e Pri m ary DPA

a nd / o r t h e N o n

- Pri m ary DPA also a g ree(s) to c o m p ly with a ll p r ov isio n s of Secti o n 483 o f t h e Hig h er Ed u cati o n Act of

1 96 5 , as a m

e nd ed.

4. Priva c y Act Statement

We use t h e i nf

o r m ation t h at y o u pr ov i de on t h is fo rm to e n r o ll y o ur A g e n cy a n d its u sers f or ser v ices w i th Fe d eral Stud e nt

Aid s y ste m s.

AUT HO RITY F OR M A IN TEN A NCE O F THE S YS T EM A N D DI S CLO S URE O F S O C I AL S EC U RITY

NUMBERS:

Title IV o f t h e Hig h er Ed u cat i o n Act of 1 965, as a m e nd e d (HEA); 2 0 U.S.C. 10 7 0 et seq. Secti o n 31 U. S.C. 7 70 1 an d

E x ec u ti v e O r der 9 397 (N ov e m b er 2 3

, 1 94 3 ), as a m

e nd e d by E x ec u ti v e O r d er 13 4 78 ( N o v e m b er 1 8 , 20 0 8) a u th o rize t h e

collection of Social Security Nu m b ers of u s ers of this sys t e m

. The Social Sec u rity N u m b er is v o lu n tary in or d er t o

identify indiv i duals for F e deral purpo s e s, but you will not be provid e d with access to or use of the system if you do not

provide a Social Security Nu m b er.

P U RPOSE ( S):

T h e i n f o r m ati o n in t h is system e n t i tled “Stu d e n t Aid I n t ern et Gateway ( S A I G )

, P a rtici p ation Ma nag em ent S y ste m ” ( 1 8

-

1 1

- 1 0 ) is m ai n tai n ed f

o r t h e p u rp oses of: ( 1 ) P r ocess i ng st o red data f r om the S A I G E nr o l l m ent For m s ( Web a n d p a per

v ers i o ns); (2) mai n tai n i n g t h e SAIG E n r o llme n t W eb site ( title d FSA W e b E n r o ll.e d .g o v) ; ( 3 ) m a n a g i n g t h e assig n m en t of

indiv i dual electr o nic S A I G m ail box n u m b e r s, kn o w n a s ‘‘ TG n u m b ers’’; a n d ( 4 ) a u t h en ticating us e rs o f t h e CPS O n li n e,

electronic Ca m

pus Bas e d (e C B) S y ste m

, N S LDS O n li n e, C o m m on Or i g i n ation a n d Di sb urse m ent (C O D) S y ste m ,Financial

Man age m ent S y stem (F M S), D e bt M an a ge m ent C o llection S y s t e m

, Fede r a l L o a n Servicers , and the Acc es s a n d I d e n tity

M a n a g e m e n t Syst e m (AIMS).

R O UTINE U SES OF R E C O R DS M AI N TAIN E D I N THE SYSTEM, INCLUDING CATEGORIES OF USERS

A N D THE P U RP O SES O F S U CH USE S :

The D e part m

e nt m ay discl o se i n f

o r m ation c ontain e d i n a r eco r d i n t h is s y stem of rec o r d s u n d er t h e r ou ti n e uses listed in

t h e system o f rec o r d s n o tice, w h ich was p u blis h ed on A p ril 1 9

, 2 0 10 ( 7 5 Fe d

. Re g

. 20 3 46

- 20 3 5 0 )

http://edo c ket.access.gpo.gov/2010 / 2 010

- 8959.htm wit h o u t t h e c o nse n t o f t h e in d i v id u al i f t h e d isclosure is c o m p ati b le

with t h e purposes f

o r w h ich t h e record w a s collected. Th e se disclosures may be ma de on a c a se

- by

- ca s e basis or, if the

Dep a rt m ent has co m

p lied wi t h t h e co m

puter m a tching r e q u ire m

ents of t h e Pr i v acy Act of 1 9 7 4

, as a m ended ( Privacy

Act), under a c o m

puter m atching ag ree m

ent.

( 1 ) Prog r a m Disclosur e s

. T h e De p art m en t m ay d iscl o se rec o r d s m ai n tai n ed in t h e SAIG, Partici p a t i o n Ma n a g e m en t

Syst e m f o r t h e p u r po se of allowing a u th o r ized u sers who are eli g i b le to p a rtici p ate in t h e elec t ronic e x ch ange o f data with

t h e De p a rt m e n t to tra n s m it fi l es to and fr o m t h e f o llowing Dep a rt m

ent syst e m s and ac ce ss the D e part m ent ' s W eb sites

onli n e

, bas e d o n t h e a pp r o v e d p r o g ram f u nc t ions o f ea c h o f t h e Dep a rt m e nt ' s s y ste m s t h at i n clu d e, b u t are not li m ited to

t h e f o llowin g :

(a) C O D S y ste m ;

( b ) CPS, un d er t h e Fe d e ral Stu d e n t Aid A pp lication File syst e m o f recor d s n o tice;

(c) eCB Sys t e m ;

( d ) NS L DS;

(e) FMS;

( f ) D M CS, u nd e r C o m m on Se r v ices f o r B o r r o w e rs ( C SB) s y stem of re c o r d s n o tice;

( g ) Fed e ral Lo a n S e rvic e rs ( T I V AS an d NF P ); a n d

( h ) AI M S.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

E ffectiv e Date : Januar y 2 014 St at e Gran t Agenc y Form Pa g e 12 

## Section Three: Re s p onsibilities of the P r imary and Non

- Pr i mary Destination Point

Administrators ( Continue d )

( 2 ) Freedom of Infor m ation A c t (FO I A) or Pr i va c y A c t Advice Disc l o sur e

. T h e D e part m ent m ay discl o se re c o rd s to

t h e D e p a rt m

e n t o f J u s tice ( D OJ) and t h e O f fice of Ma n a g e me n t a n d Budget (OMB), if the D e p art m e n t see k s ad v ice

reg a rd i n g w h e t her re c o r d s m aintained i n t h e s y stem of re co rds are r e qu i r e d to be releas e d u n d e r the FO IA o r the P riv a cy

Act o f 1 9 7 4

.

( 3 ) Discl o sure to the D O J

. T h e D e p art m en t m ay d iscl o se rec o r d s t o t h e DOJ to t h e e x t e n t n ecessary f o r o b tai n ing DOJ

a dv ice on a n y matter rele v a n t to an a ud it, i n s p ecti o n, o r o t her inq u iry rela t ed to t h e pro g r a m s c ov e red by t h is syste m

.

( 4 ) C o nt r a ct Disc l o sur e

. If t h e De p a rt m e n t c on t rac ts wi t h an e n tity for t h e purp o ses of p e rf o r m i n g any fu n ction t h at

req u ires d isclos u re of recor d s in t h is system to e m ployees of the contrac t or, t h e D e part m e nt m ay disclose the records to

those e m ployees. Before ent e ring in t o s u ch a contract, t h e Dep a rt m en t shall require t h e c on t

ract o r to mai n tain Pri v acy Act

safe g u a rds as r equ i red un d er 5 U. S .C. 5 5 2 a( m ) with res p ect to t h e rec o r d s in t h e syste m

.

( 5 ) Li t i g a ti on a nd Alt ern a t i v e Di spu te R es o lu t i o n ( ADR) Di scl o sures

. In t h e e v e n t o f s p ecified litigati o n o r ADR, if

t h e D e p a rt m

e n t deter m i n es t h at discl o s u re o f re c o r d s t o t h e DO J

, or att o rn e y s e n gag e d b y DO J

, a n ad j u dicati v e b o dy

be f o re w h ich t h e Dep a rt m

ent is au t h o rized to a ppe a r, an i n divi d u al or ent i ty desi g n ated b y t h e D e p a rt m ent o r oth e rwi s e

e m pow e r e d to reso l v e or m

ediate dis p utes, a p a rt y

, c ou n sel, r e pres e n tati v e or wit n e s s in a n a d m inistrati v e p roce e di n g is

rele v a n t and n e cessary to t h e l iti g ati on

, t h e De p art m e n t m ay d i scl o se th o se records as a ro u tine u se t o any o f t h e fore g o i n g

i nd i v i du als or e n tities

.

( 6 ) Res e arch Disclosure

. T h e Dep a rt m ent m a y disclose records t o a re s earch e r if an a p pro p riate off i cial of t h e

Dep a rt m ent deter m i n es t h at t h e i n div i d u al o r o r ganizati o n t o whi c h t h e di s cl o s u re w o uld be m ade is q u a lified to c a rry out

s p ecific research related to fu n cti o ns o r p u rp o ses o f t h is sys t em of re co rd s

. T h e o f ficial m ay disclose records from this

syst e m o f recor d s to t h at researc h er s o lely f o r t h e p u r p o s e o f carryi n g o u t t h at research related to t h e fu n cti o ns o r

p ur poses o f t h is s y stem of re c o r d s. T h e researc h er s h all b e req u ired to m a in tain Pri v acy Act safeg u ar d s with res p ect to

the disc l o sed records.

( 7 ) Congress i onal M e mber Disclosur e

. T h e Dep a rt m ent m a y discl o se i n f

o r m ation to a m e m

b er of C o ng ress f

r om the

record of an i n d i v id u al in res p o n se to an i n q u iry fr o m t h e m e m b er m a d e at t h e written re qu e st of t h at i nd i v id u al. T h e

M e m b er’s right to t h e i n formati o n is no g reater t h an t h e r i g h t of t h e in d i v i du al w h o requested it.

( 8 ) Disclo s ure for Use by L a w Enforc e m e nt Ag e ncie s

. The D e part m e nt m a y discl o se i n f

o r m ation t o a n y F e deral,

State, l o cal or oth e r a g encies res po n sible f o r e n f o rci n g, i n v esti g ating, o r p rose c uti n g vio l ations of ad m inistrati v e, civil, o r

crimi n al law or re gu lation if t h at infor m ati o n is rele v a n t to a n y e n f o rce m e n t, reg u latory , i nv e sti g ati v e or p r o sec u t o rial

respo n si b ility wit h in t h e e n tity’s juris d icti o n.

( 9 ) Enforce m ent Disclo s ur e

. In the e v e n t that infor m ati o n in this syst e m of records indicates, eith e r on its face or i n

c o n n ection with o t h e r informati on

, a v i o lati o n or p o te n tial v i o lati o n of any a pp lica b le stat u te, r e g u lati on

, or o r d er of a

c o m p ete n t a u th o rity, t h e De p a rt m e n t m a y d iscl o se t h e releva n t re c o r d s t o t h e a p pr o p riate agency, whether foreign,

Fe d e ral, State, tri b al, o r l o cal, c h ar g e d with t h e respo n si b ility o f i n v esti g ati n g or p r o sec u ti n g t h at v i o lation o r c h ar g e d

with e n f o rc i n g or i m

ple m enting t h e statute, E x ecuti v e Or de r

, r u le, re g u lati o n, o r o r der iss u ed p u r s uant t h e reto.

( 1 0) Emp l oyment, Benef i t, a n d Cont r a cting Disclosur e

. T h e D e part m ent m ay discl o se re c o r d s t o a Fed e ral, State, or

l o cal a g e n cy mai n tai n ing ci v i l

, cri m i n al, o r ot h er rele v a n t e n f o rce m ent o r oth e r perti n e n t rec o r d s, or to a no t her pu b lic

authority or profess i onal org a n i zation, if ne c essary to obtain infor m ation rel e vant t o a D e part m ental or re ceiving e n tity’s

decisi o n c onc e rn i ng t h e hir i n g or retenti o n o f a n e m plo y ee or o t

her p e rs on n el acti o n, t h e issuance of a s ecurity clear an ce,

t h e letting of a con t

ract, or t h e issu a n ce of a l icense, gr a n t, o r other b e n e fit.

( 1 1) Emp l oy e e Grievanc e , Co m pla i n t or Condu c t Disclosur e

. T h e D e part m ent m ay discl o se re c o rd s to an other

a g e n cy of t h e Fe d e ral Go v er n m e n t if t h e rec o rd is rele v a nt to o n e o f t h e f o ll o w i ng pr oc e edi n g s reg ar d i n g a pres e n t or

for m er e m ployee of the D e part m

ent: co m p laint, gri e vanc e

, discip line or c o m p etence de t er m ination proceedings. The

discl o s u re m ay o n ly be m ade d u ri n g t h e c o ur se o f t h e pr oc e edi n g

.

( 1 2) L a b o r O rg a ni z a tion D i scl o sur e

. T h e Dep a rt m ent m ay discl o se re c o r d s t o a n a rbi t rator to re s o l v e di s putes u nd e r a

n e g o tiate d g r ie v a n ce pr o ced u r e o r t o o ffi cial s o f lab o r or g a n i zati on s r e cognized un d er 5 U.S.C. c h a p ter 71 w h en rele v a nt

and nec e ssary t o the i r duties of e x cl u si v e represe n tatio n

.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

E ffectiv e Date : Januar y 2 014 St at e Gran t Agenc y Form Pa g e 13 

## Section Three: Re s p onsibilities of the P r imary and Non

- Pr i mary Destination Point

Administrators ( Continue d )

( 1 3 ) Disclo su re in t he C o u r se o f R e sp o nding to a Bre a ch of D a ta

. T h e D e part m ent m ay discl o se r eco r d s t o

a p pr o p riate age n cies, e n tities, and p ersons w h en (a) t h e De p art m e n t s u s p ects o r h a s c o nfir m ed t h at t h e sec u rity or

c o nfi d e n tiality o f i n for m a t i o n in t h is system h as b een c o m p r o m ise d ; (b) the De p art m e n t h as d eter m i n ed t h at as a res u lt of

t h e s u s p ected or c o nfir m

ed co m p r o mise, t h ere is a risk o f h a rm to ec o n o m i c or p r op e rty i n terests, i d e n tity t h eft o r fraud or

harm to t h e s e c u rity o r i n t e gri t y of t h e s y stem o r other s y ste m s or p r o g ra m s ( whe t h er m aintai n ed by t h e Dep a rt m e nt or

a no t h er a g e n cy or e n tity) t h at rely u p on t h e c o m p r o m ised i n for m a t i on ; a n d (c) t h e d iscl o s u re m a d e to such a g e n cies,

entities, or other persons is r e asonably necessary to a ssist in conne c tion w i th the D e partment’s e fforts to respond to t h e

su s p ected o r c o nfir m ed co m p ro m ise and pr e v ent, m inimiz e , or re m edy such har m

.

By si gn ing b e l o w, I certify t h at I h a v e read t h ese res p o n si b i lities, u n d ersta n d t h e m , a g ree to f u lfill t h e res p o n s i b ilities, a n d

will p r o tect all d ata o b tai n ed t h ro u g h o r pr o v i d ed t o U.S

. De p art m e n t o f E du cation syste m s.

De sti n atio n Poi n t A d m i n i st ra to r ’s Na m e

(Printed name)

Si gn a t u re

(Must m at c h n a m e i n Question 4

- origin a l s i gnature m u s t be su b mi t ted) _ D ate

P r i m a ry De sti n ati o n P o i n t Admi n i st ra t o r’s N a m e

(Printed name)

Si gn a t u re



## Sign and send this form as instructed

In “ Submitting Enrollment Form and Signature Pages ”

Go to Section Four

Office Use Only

Customer Num

b er

TG NumberOMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 14 

## Section Four: Certification of the President/CEO or Design ee

Desig na ti o n o f A u t h ori z ing Official

If y o u as t h e Presi d e n t o r CEO wish t o d es i gn ate s o m e on e o t h e r t h an yourself t o sign SAIG E n r o ll m en t f o r m s, you may d o so b y

c o m p leti n g t h e d es i gn ation s t at e m e n t b elow a n d sig n ing B o x 1

, and h a v i ng your d esig n ee c o m p lete a n d sign Box 2

.

I h ere b y d e sig n ate Title , to b e my res p o n s i b le a u thorizi n g official for all

f u t u re Fe d e ral St ud e n t Aid Syst e m E n r o l l m en t f o r m s. All rel a ted res p o n s i b ilities o f t h e Presi d e n t/CEO s h all b e carried ou t b y t h is

d esig n ee. I agre e to ass u m e t h e res p o n s i b ility f o r s u ch actio n s ass o ciated with t h is and f u ture e n r o ll m en t agree m

e n ts. T h is

d esig n ation is effecti v e as o f t h e d ate sig n ed b elow.

Bo x 1

Presi d e n t/CEO Title

(Printed na m e of President/CEO) (Printed tit l e

- Req u ir e d)

Si gn a t u re

(Original signature m u st be su b m

itte d ) Da te

Resp o nsibilit i es of the President/C E O o r Desi g n ee

As the Presi d e n t/CEO o r Desi gn ee I certify t h at:

• I o r m

y d esignee will n o tify CPS/SAIG Tec hn ical Su p port wit h in o n e b u si n ess d ay, b y e

- m a i l at C PSSAIG@ e d

. gov or

call 1

- 8 0 0

- 3 3 0

- 59 4 7 w h e n an y per so n no l o ng e r s er v es as a des i gnat e d a u t h orizi n g o f f i cial, Pri m ary DPA or No n

Pri m ary DPA.

• I will no t p er m

it un a u th o rized u se or s h ar i n g o f SAIG p assw o r d s o r c od es t h at h a v e b een i ss u ed to a n y o ne at my A g e n cy.

• Each person who is a SAIG DPA for m y agency h a s re a d a n d sign e d a co py of t h is form at “Section Th ree:

Res p o n s i b iliti e s of t h e Pri m a r y a n d No n

- Pr i m ary DPA.”

• Each pe r s o n w h o is a S A IG D P A fo r m y agency h a s m ade a c o py o f t h e s i gn e d Secti o n T h ree d o c u m ent f o r his or h e r

o w n files and a co p y is m ai n t a i n ed at m y A g e n cy.

• My A g e n cy h a s pro v i d ed sec u rity d u e d ili g e n ce a n d v e rifies t h at a d m i n is t rati v e, o p eratio n al, a n d tech n i cal sec u rity

con t rols a re i n place and are operating as int e nd e d. Additionally, my Ag e n cy v e rifies t h at it perfor m s appropriate due

diligence to en sure that, at a min i m u m

, any e m

ployee who has access to Feder a l Student Aid (FSA) ISIR data m eets

a pp lica b le state security require m e n ts f o r p e rson n el h a n d li n g se n siti v e p e rso n ally i d e n tif ia b le i n f o r m at io n.

• I h a v e sig n ed t h is certification b elow a n d se n t t h e ori g i n al t o t h e D e p a rt m ent. I h a ve re t ai n ed a c o py of t h is

certificati o n at t h e A g e n cy. My si gn ature bel o w aff i r m s t h at I h a v e read t h ese res p o n si b i lities a n d a g ree to a b i d e b y

t h e m

.

Bo x 2

State Sc h o lar s hip an d Gr a n t Ag e n cy P resi d ent/CEO or D e signee

Title

Si gn a t u re (Printed n a me) (Printed tit l e

- Req u ir e d)

Da te

(Original s i gnature m u st be su b mitted)

Na m e o f A g enc y



## Sign and send this form as instructed

in “ Submitti ng Enrollment Form and Signature Pages ”

U.S. Department of Education:

Received on behalf of the U.S. Depar t ment of Education:

Date Office Use Only

Customer Num

b er

TG NumberOMB NO: 1845

- 00 02

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 15 

## Section F i ve: Federal Student Aid User of Electronic Services Statemen t

Any i nd i vidual who is not a Destination Po i n t Ad m inistrator and who acc es ses F e deral S t udent Aid syste m s and/or uses re s o urces t h at

access F e deral Stud e nt Aid syst e m s, whe t her by batch or online, m u st read and s i gn this s tat e m ent. The or i g inal F e d e r a l Stud en t Aid

User of Electronic S e rvices Stat e m ent m u st be m a i n tai n ed by t h e A g e n cy. T h e u ser s h ou l d keep a c opy of t h e s i gn e d state m ent f o r his

or h e r rec o r d s.

The us e r u n de r stands t h at i n t e ntional s u b m i s sion o f false o r m isleading i n f o r m ation to t h e U

. S. D e part m ent o f Ed ucati o n is su b j ect t o a

fine u p to $1 0

, 0 0 0

, i m

priso nm ent f

o r up to five y ea r s, or b o t h

, un d er p r ov isions o f t h e U n ited States C r i m i n al Code (incl u di n g 18

U. S .C. 1 00 1 ) . The us e r also a g rees to c o m p ly with all pr ov i sions o f s ecti o n 4 8 3 o f t h e H i gh e r Ed ucati o n Act of 19 6 5

, a s a m end e d.

The us e r u n de r stands t h at t h e i n f o r m ation pr ov i ded by t h e U. S

. Dep a rt m e nt o f Ed ucati o n is p r otected b y t h e P ri v acy Act o f 1 9 7 4

, as

a m e nd ed. Pr o t ecti n g t h is infor m a t i on

, o n ce i t is e n tr u sted to t h e u ser, b ecomes h is or h er respo n si b ility. T h eref o re, the u s e r a g rees to

p r otect t h e p ri v acy of all i n f o rm ation p r o v i d e d to him or her by t h e U .S. D epart m ent of E ducati o n. T h e user un d erst an ds t h at a ny

p erso n

, i n clu d i n g h i m self o r herself, who k n o w i ng ly a n d willf u lly r eq u ests or ob tains any record co n cer n i n g an in d i v i du al fr o m an

a g e n cy u nd e r false p rete n ses, s h all b e g u ilty o f a m is de m e an o r and is su b ject to a fi n e of u p to $ 5

, 0 00 (5 U.S.C. 5 5 2a(i)(3)).

Resp o nsibilit i es of the Electr o nic Ser v ices User

A p p ro p riate u s e s o f F e d e ral S tud e nt A i d s y s t e m s by an Ele c tr o n ic Se r v ices Us e r:

 Must use Electronic S e rvices co m puting re s o urces o n ly f

o r official g o ver n m e n t bu s i n ess.

 Must en su re that the FAFS A applicant is a r e sid e nt of the state wh er e the Ag e n cy i s located or h a s i n clu d ed o n t h e FAFSA a

p o stsecon d ary institution t h at is located i n the state w h ere t h e Ag e n cy is l o cated, b e fore accessing F e d e ral Stud e n t A i d syst e m s to

ob t ain privacy p r otected i n f o rm ation a bo u t t h e s t ud e nt.

 M u st kn o w t h e na m e of t h e Pr i m ary DPA a n d h o w t o c ont a ct t h at i n divi du al.

 Must protect a l l Fed e ral Stud e n t A i d syste m s from access by or disclosure to un a u thoriz e d per s onnel.

 M u st rep o rt imme d iately to t h e Pri m ary DPA a n y sec u rity i n c i d e n ts, po te n tial t h reats, or v u l n era b ilities t h at in vo l v e E l ectro n i c

Services.

 M u st rep o rt to t h e Pri m ary DPA a n y c o m p r o m i se, suspec t ed c o m

p ro m is e s, or i n cid e nts of sh a ri n g of a pas s w o rd o r an y oth e r

auth e n ticator.

 Must access only those syst e m s, network s

, data, c on t rol i n for m ation, an d sof

t ware for which he or s h e i s au t h orized.

 Must ensure that all Electron i c Services i nfor m a t ion is m arked according to its s e nsitivity and is prop e rly controlled a n d stor ed.

 Must inform the Agenc y ’s Pr i m ary DPA that the Electronic Services User no long e r ne ed s access t o a Federal Student Aid system

(i.e., t h e i nd i v i du al is lea v ing h is o r h e r po si t i o n or h is or h e r j o b res p o n sibili t ies h a v e c h a ng e d).

 M u st n o t a d d c ode t h at m ight be har m ful to t h e S A I G o r E l ectr o nic Se r v i c es.

M y signat u re b elow a ff

i r m s that I have re a d t

h is State m ent and agree t o a b i d e b y t h ese r u les.

TG #

Elect ron ic S er v ice s Us er ’s N a m e

(Pri n t)

Electr on ic Ser v ice s Us er’ s Jo b Titl e SSN

_

Ph on e # (

_ )

Elect ron ic Ser v ice s Us er ’s Si gn a t u re D ate

_

P r i m a ry DPA Si gn a t u re Da te

_

(This s ta tem e nt w ith a n ori g inal sig n a t u r e must be ma i ntai n ed b y the Prima r y D P A.)



### Do Not Submit This U s er Stat e m e nt to the D e partment o f Education.

The Origi n al Must Be Retained By The Agency.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 16 

## Part T w o: SAIG P a rticipation Agreement for State Grant Agencies

Instructions for Signing the SAIG Pa r ticipation Agre e ment

In order to participate in the SAIG to a c cess da t a ele c tronically that resides in the U.S. Department of Education ’ s data

s y stems (including receiving data on In s titutional Student Infor m ation Records (ISIRs)), t h e President/CEO of the State

Grant Agen c y m

u st c o m p l ete and sign this SAIG Participation Ag r eement (Agree m ent).



### Terms of t h e Agreeme n t

A. Parties to the Agre e ment

1

. The U.S. Depart m ent of E d ucation (referred to as the Depar t ment) a d m inisters c ertain Federal progra m s,

authorized under the Higher E ducati o n Ac t o f 196 5 a s a mende d (th e HEA)

, that p rovide financial ass i stance t o

students attending i n stitut i ons of h i gher education.

2

. Th e Agency

( Name of Sta t e Grant Agency administering S t ate hi gh er education f inancial aid p rogra m

, refe r red to as th e Agenc y )

locate d at

(Street address, City, State, ZIP Code)

in the State of ad m inisters St a

t e p ro g r a m s th a

t

provide fina n cial assistan c e to students attending ins t itutions of hi g h er education.

B. Purpose of the Agre e m e nt

1

. The purpose of this Agreement is to es t ablish the c o nditions under which the Depar t ment will provide to the

Agency certain data received or g e nerated by the Depar t m e nt concerning FAFSA applicants in ord e r to: (i)

facilitate and i m

prove the awa r d i ng of financial ass i s t a nce u nder State financial ai d p rograms to s t udents

attending institut i ons of h i gher education; (ii) coo r dinate the awarding of su c h assista n ce with financial ai d

provided b y t h e Federal government under the HEA; (iii) facilitate and i m prove the awarding of financial

assis t ance awarded by eligible institutions; and (iv) per m it the Agency to disclose l i mited ISIR information

to local educ a tional agencies ( LEAs), seco n d ary schools, or other entities that have been designated by the

U.S. Secret a ry of E ducation (Designated Enti t y ), to deter m in e the co m pl etion status of a student ’ s Free

Application for Federal Stud e nt Aid (FAFSA) and facilitate providing assistance to such students in

co m p leting the FAFSA.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 17 

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

C. Definitions

- For purposes of this Agreement, the f ollowing definitions appl y :

1

. Author i z ed Personnel

- (i ) E m plo y ees of the Agency who require acc e ss to the ISIR Data to meet any of the

purposes provided in Section B of this Agre e ment, including both paid and non

- p aid staff and authorized

agents such as contractors, subcontractors, volunteers, or other part i es to whom the Agency has outsourced

any of its services or functions. All Au t horized Personnel m u st be under the dir e ct control of t h e Agency w i th

respect to the use and maintenance of ISIR Data. ( ii) E m plo y ees of an LEA, seconda r y school, or Designated

Entity who require access to the FAFSA Filing Status Infor m ation to deter m ine th e co m p leti o n status of a

student ’ s Fr e e Application for Federal Student Aid (FAFSA) and facilitate providing assistance to such

students in c o m

p leting the FAFSA, including bo t h p a id and non

- p a id staff and authorized agents such as

contractors, subcontractors, volunteers, or other p a rt i es to whom th e LEA, sec o nda r y school, or Designated

Enti t y has ou t sourced any of its serv ices or functions. All Authorized Personnel m u st be under the direct

control of the LEAs, seco n d ary schools, or Designated Enti t y with respect to the use and maintenance of ISIR

Data.

2

. Designated Entity

- A public or non

- profit entity that has an Establ ished Relationship with the stude n t

t hat the U.S. Secreta r y of Ed u cation has designated as eligible to receive FAFSA Filing Status Information from

an Agency

. 3

. Destination Point Administrator

- The one Prima r y Destination Point Ad m inistrator (Pr i mary D PA) at each

Agency as appointed a n d enrolled in t o t h e SAIG by t he Agency P r esident/CEO or Designee. Each Agency

may have as many Non

- P r i m ary Destination Point Ad mi nistrators (Non

- Prima r y DPAs) as it needs who are

appointed a n d enrolled in t o the SAIG by the Pri m ary DPA.

4

. Established Relationship

- A relationship between a student FAFSA applicant and an LEA, secondary school,

or Designated Enti t y. In t h e case of an LEA, an Established Relationship exists where th e student FAFS A

a pp lica n t i s enrolle d i n a secondar y schoo l und e r th e lega l authorit y o f t h e LEA or the LEA otherwise is

provid ing services to the FAFSA applicant

. I n t h e ca s e o f a secondary school, an Established Relat i onship

exists where the student FAFSA applicant i s e nrolle d i n th e secondar y sc h oo l itself or the secondary school

otherwise is provid ing services to the FAFSA applicant

. I n th e cas e o f a Designate d E n tit y

, an Esta b lis h ed

Relati on s h ip e x ists w h en t h e st u d e n t FAFSA applicant is enrolled in or has regi s tered with or is receiving

servic es from the Designated Entity in order for the Designated Enti t y to assist the student in pursuit of

postsecondary education

. 5

. FAFSA

- The Free Application for Fe d eral Student Aid for m

, authorized b y H EA section 483, which is t h e

Depar t ment’s common ap plication for d e ter m ining the need and eligibili t y of a student for F e deral student aid.

6

. FAFSA Filing Status Information

- Information from an ISIR that the Agency may disclose to LEAs,

secondary schools, and Designated Enti t ies on the co m p l e tion stat us of a student’s FAFSA. FAFSA Filing

Status Information include s : Studen t ’s f i rst na me; Student’s last n a me; Stud e nt’s date of birth; Studen t ’s Z I P

Code; FAFSA sub m

it t ed date (the d a te the FAFSA was su b m itted to the Depar t m ent); FA F SA processed date

(the date the Depar t ment proces s ed the FAFSA); a S e lected for V erification flag; and a FAFSA c o m p letion

flag, as determined by the Agency (e.g., FAFSA not sub m itted, FAFSA c o m

p le t e, or FAFSA inco m

p lete).

7

. ISIR

- The Institutional S t udent Infor m ation Record (ISIR) is the ou t put docu m ent resulting from the

sub m is sion of a FAFSA to the Department and includes the data received, s y st e m gen e rated data results and

FAFSA Filing Status Information

. 8

. LEA

- A Local Educational Agency is a public board of educatio n or other publ i c authori t y l e gally constituted

within a State for either administrative control of or d i rection of, or to perform service functions for, pub l ic

elementary or secondary schools in a ci t y

, coun t y, townshi p

, school district, or other politica l subdivision of a

State; or such co m

b ination of school dis t ricts or coun ti es a State r ecognizes as an a d m inistrative agency for i ts

public elementary a n d seconda r y scho o ls; or a n y o th er public inst i tution or age n cy t h at has administrative

control and d i re ction of a p ublic ele m entary or secondary schoo l

. 9

. Secondary School

- A d a y or residential school that provi d es secondary education as dete r m i n ed under Sta t e

law. In the absence of State law, the S e cretary may det e r m ine, wi t h respect to that State, w hether the te r m

secondary school applies.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 18 

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 20 D. Authority

1

. Section 483 ( a)(10) of the HEA, 20 U.S.C. 1090(a)(10) authorizes the Depar t ment to disclose FAFSA (ISIR)

data. The Depar t m ent ’ s routine uses in t h e applicable S y stem of Records Notice publishe d under the Privacy

Act of 1974, as amended, (5 U.S.C. 5 52 a) per m its this disclosure of FAFSA data to the Agency i n order to

per m it the Agency t o determine an a pplicant’s eligibi l ity for financ i al assistance under State f i nancial ai d

progra m s. Fu rther, in order to encourage and assist students with the co m p leti o n of a FAFSA, the Agency

may disclose the FAFSA Filing Status I n for m ation of a student to an entity with an Established Relationship

with the student, including an LEA, a secondary school, or a Desig nated Enti t y

. (Federal Student Aid

Application File S y st e ms of Record Notice (Aug. 3, 2 01 1

, 76 F e d

. Reg. 46 77 4

, 4 6 777

- 78.)

E. Disclosu r e of ISIR Data

1

. At the agency’s request, t he Depar t ment will p r ov i de st ud e nt ISIR data to the Age n cy i f t h e student is a

resident of the State where th e Agency is lo c ated or the student has inc l uded on the F AFSA a postsecondary

i n stitution that is located in the State where th e Agency is located.

F. Author i z ed Uses

1

. The Agency m

u st l i m it a c cess, disclos u re and us e of I S IR data provided to it under this Agre e m ent to the

Agency ’ s Au t horized Personnel and for t h e authorized uses described in this sect i on and t h e Authorized Re

Disclosure of FAFSA Filing Status Info r mation in the next section.

2

. The Agency agrees to c o m p l y with all p r ovisions of t h e Higher Education Act of 1965, as a mended (HEA), 20

U.S.C. 1001 et seq., including HEA sec t ion 483(a)(3 ) (E), 20 U.S. C

. 1090(a)(3)(E), which provides that ISIR

data (including FAFSA Filing Status In f o rmation) may be used “on ly for the application, awa r d, and

a d m inistration” of student aid awarded by the Departmen t

, States, and institut i ons eligible to participate in the

Federal s t udent financial assis t ance progra m s, a n d other entiti e s that the Secretary m ay designate.

3

. The Agency may use the I SIR data furnish e d to it under th i s Agree ment on l y with regard to t h e a d m inistration

of a State ’ s and the Federal gover n m ent ’ s p r ogra m s o f fin a ncial assistance to st u d ents attendi n g institut i ons of

higher education, inc l udi n g calculatio n of State student financial aid awards, re sea rch nec es sa r y for the proper

ad m i n istration of a State s t u d en t a i d progra m

, and verification of data pr o v ided b y t h e applicant on State

student aid applications.

4

. The Agency m a y u s e th e I S I R d a t a t o disclose to the publ i c statistical s u mmary da t a obtained from the

infor m ation furn i shed b y t h e De p ar t m e n t

, pr o v ided t h at the i d enti t y of indiv i dual Fede r al student aid

applicants cannot be ascer t a i n ed from such summary data.

5

. Consistent with applicable law, the S ecretary of E du c ation m ay designate, thro ug h an adden du m to this

agreement, additional authorized uses of ISIR data furnished by the Depar t ment.

G

. Disclosure o f F A F S A Fi l in g S t atu s I n f or m a t i o n

1. T h e A g e n c y ma y d i scl o s e a stu d ent ’ s FAF S A F i li n g S t at u s In f or m a t io n t o an L E A , secondary s c ho ol

, and

Designated En t it y t h a

t h a s been approved by the Secretary, if the LEA, secondary school or Designated Entity h a s a n

E stabl i she d Relat i o n shi p w i t h t h e s t ude n t

.

2. Before an A g ency discloses FAFSA Filing Status I n fo r m ation to an LEA, seconda r y school, or Designated

Enti t y

, it m

u st execute a w r itten agree m ent with the L EA, seconda r y school, or Designated En ti t y. The

agre e ment m

u st, at a m

i ni m u m

, incl u d e:

(i) Procedures for ov e rsight b y t h e Agency of t h e LEA’s, seconda ry school’s, or Designated Enti t y’s

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 21 compli a nce with the provisions of the written agree m ent;

(ii) Appropriate privac y

, data security and infor m ation safeguarding provisions consistent with the Agency ’ s

obligations u nder this Ag r eement, including t h e requ i re me n ts s p ec i fied in Section J

- Data Security below;

(iii) Assurances that the FAFSA Filing S t atus Informa t ion will be u s ed by the L E A, secondary school, or

Designated En ti t y on l y f

o r purposes consistent with se c tion 483(a ) (3)(E) of the HEA;

(iv) Assurances that the LE A, secondary school or Designated Enti t y will co m p l y

, as applicable, with the

require m e nts of the F a mily Educational Rights and P r ivacy Act ( F ERPA) (20 U.S.C. 12 3 2g a nd its

regulat i ons codified at 34 CFR part 99) in disclosing a n y personally identifi a ble infor m ation from students’

education records to the Agency or its agents;

(v) Assurances that the disc l osures will on l y be m ade t o Authorized Personnel , as defined in section C. of this

Agreement, of t h e LEA, secondary school, or Designated Enti t y and for aut hor i zed purposes described in

Section B

– Purpose of the Agreement above; and

(vi) Assurances th at the LEA, secondary school, or Designated Enti t y will not re

- disclose or share the F A FSA

Filing Status infor m ation obtained f rom the Age n cy i n person a lly identifia b l e form other than ( 1 ) to t h e

FAFSA applicant and to t h e FAFSA applicant’s parents if the appl i cant is under age 18, to t h e applicant if

t h e applicant is age 18 or o l d e r or enroll e d in a p o st

- seconda r y insti t ution, or to a n y other par t y w ith the

conse n t o f the FAF S A applicant or the consent of the FAFSA applicant ’ s parents if the FAFSA applicant is

under the age of 18, or ( 2 ) if req u ired to do so b y law and if such use is consistent with all applicable

privacy laws, including the privacy prov i sions of sect ion 4 83(a)(3) ( E) of the HEA, 20 U.S.C. 1090(a)(3)(E)

and the Fa m

i ly Education a l Rights and Privacy Act ( 20 U.S.C. 12 32g).

3

. T h e written agree m ents must be made available to the Depar t ment upon request.

H. Prohibition on Unautho r ized Disclosures

1 . Any use, disclosure, or re

- disclosure of ISIR data or FAFSA Filing Status Info r mation prov i ded to the Agency

u nd e r this Agreement not specified in Section G

– Disclosure of FAFSA Filing Status Information above, is

un a uthorized and pro h ibit e d.

2. The Age n cy m

u st ensure that Authori z ed Personnel are infor med about and a w are of the prohibitions regarding

t h e use, disclosure, and re

- disclosure of a n y data and in f o r m ati o n pro v ided to the Agency under this Agre e ment.

I. Reporting of Unauthorized Disclosures

1

. The A gency will report to the Depar t ment in writing any use, disclosure, or re

- disclosure of ISIR data or

FAFSA Filing Status Info r mation not a u thorized b y t h is Agre e men t

. The Agency shall sub m i t the report

within one (1) business day after the Agency learns of such unauthorized use, disclosure, or re

- disclosure to :

U.S. Depar t ment of Education, Federal Student Aid, 830 First St. N E., Union C e nter Plaza, R oom 32E1,

Washington, DC 20202 or via e m ail at F AFSAC o m pl etion@ed.go v

. The report m u st identify: (i) the nat u r e

of the unau th o rized use, disclosure, or re

- disclosure; (ii) the ISIR data or FAFSA Filing Sta t us Infor m ati o n

used, disclosed, or re

- disclosed; (iii) the person or enti t y, if known, who made the unauthorized use or

received the unauthorized disclosure, or re

- disclosure; (iv) what the Agency has done or will do to noti f y

affec t ed FAFSA applicants and to m itigate any deleterious effect of the unauthor i zed use, disc l osure, or re

disclosure; and (v) what corrective acti o n the Agen c y has taken or will take t o p r event future s i m ilar

unauthorized use, disclosure, or re

- disclosure.

2

. The Agency s h all also provide any such other i n for m a tion concerning the unauthorized disclosures as

requested by the Department.

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 22 J

. Data Securi t y

1

. The Agency will protect the integri t y of the ISIR data and, if appl i cable, FAF S A Filing Sta t us Infor m ati o n

received under this Agreement from unauthorized access, use or re

- d isclosure. 2

. The Agency s h all take

all steps necessary to safeguard the confidentiality of the d a ta received. The Agency will restrict access to

the data provided or created under this Agree ment to on l y those Autho r ized Personnel who need the data to

perform their o ffic i al duties in connection with the uses of the data authorized in this Agreement.

3. T he Agency will advise all Authorized Personnel who have access to the data of the confidential nature of

the data, the safe g uards required to protect the data, and cr i m inal sanct i ons for nonco m pliance under

app l icable Fed e ral, state, or local laws.

4

. The Agency m

u s t develop, i m

plement, maintain and use reasonab l e and appropriate a d m inist r ative, technical

and ph y sical security m easures to prese r ve the confi d entialit y

, int e grit y

, and availability of all data

electronically maintained or trans m itted pursuant to this Ag reemen t

. The Agency will process the data

provided or c reated under this Agreement under the i m mediate supervision and c o ntrol of Au th orized

Personnel in a m anner that will protect the confident i ality of the d a ta, so that un a uthorized pe r sons cannot

retrie ve any d ata by co m

puter, re m o te ter m

inal, or ot h er m e ans. Systems personnel m u st enter personal

identification nu m

bers wh e n acce s sing data on the Parties’ s y st e m s.

K. Liability

1

. The Agency s h all be liable for the actions and o m i s sions of its respectiv e officers, e m plo y ees and agents.

This obligat i on shall surv i v e ter m ination of this Agr e e ment.

L. Oversight and Compliance

1

. The Agency s h all maintain copies of this Agreeme n t and all SAIG Enroll m ent Fo rms su b m it t ed to the

Department, as provided i n Pa rt 1, Sections One thr o ugh F our of the SAIG Enrollment Form for State Grant

Agencies.

2

. The Depar t ment ma y

, at its discretion, m onitor the Agency ’ s records, processes, procedures, and electronic

s y stems for co m

p lian c e w i th the terms of this Agre e ment. The Depart m ent also ma y

, at its di s cretion,

perform on

- s i te inspections of the Agency to m onit o r c o m p liance with the ter m s of this Agreement.

M. Entire Ag r e e m ent

1

. This Agreement constitutes the entire understanding of the Parties with respect to their ind iv i dual rights and

obligations in carr y ing out the ter m s of the Agreement, and supersedes any prior or conte m poraneous

agreements or understand i ngs.

N. Effective Da t e, Modification, Duration, and Term i nation of the Agre e ment

1

. The effective date of t his agree m ent is u pon t h e Depart m ent’s noti f ication to the Agency that t h e Agency’s

SAIG applic a tion has been processed a n d approved by the Department. The Parties of the Agre e ment m a y

m odify this A g ree m ent at any ti m e with m u tual writ t en consent.

2

. Thi s Agreement shall remain in fo r ce until ter m ina t ed by t h e Agency or the Depar t ment, providing that the

party requesting ter m inati o n provides the other par t y with written notice.

3

. If the Depar t ment finds that the Agency has failed to c o m p ly with t h is Ag reement, the Agency shall, upon t h e

request of the Department, delete or return all data received under t h is Agreement and copies made of such

data. Further m ore, the Depart ment m ay ter m inate t h is Agre e ment or take such other action as may be

necessary and appropriate to protect the interests of the FAFSA applicants, the United States, and the Title IV,

HEA Fe d eral student aid pr o g rams.

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 23 4

. The expiration of this Agr e e m ent shall n o t, however, af f ect the obligations incur r ed b y the Ag e n cy under t h i s

Agre e men t.

Remainder of this page intentionally left blank.

### Part T w o: SAIG Participation A g ree me n t for State Gra n t Agencies (Continued)

OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: Ja n u ary 2014 State Grant A g ency Fo r m P a g e 24 O. SIGNATURE PAGE

1

. The undersi g ned has caused this Agreement to be d u ly executed in its name and on its behalf.

N a me of the State Grant Ag ency

Address of the State Grant Agency

Printed na m e of the Agency President/CEO Printed Title

Signature of the Agency President/CEO Date



## Sign and send this form as instructed

in Submitting Enrollment Form and Signature Pages

U.S. Department of Education:

Received o n behalf of the U.S. Depar t ment of Education:

Date

Office Use Only

Customer Num

b er

TG NumberOMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: January 2014 State Grant Agency F o r m Pa g e 22 

## Attachment A: Glossary

Authorized P ersonnel: (i) E m plo y ees of the Agency who require acce s s to the ISIR Data to meet any of the

purposes provide d in Section B of th e SAIG Participation Agre e ment for State Grant Agencies (Part 2 of

the SAIG A pplication for State Grant Agencies )

, including both paid and non

- p aid staff and authorized

agents such as contractors, subcontractors, volunteers, or other p art i es to whom the Agency has outsourced

any of its services or functions. All Au t horized Per s onnel m u st be under the dir e ct control of t h e Agency

with respect to the use and maintenance of ISIR D a ta. (ii) E m plo y e es of LEA, seconda

r y sch o o l, or

Designated En tity who require access to the FAFSA Fil i ng Status Infor m ation to deter m ine th e co m p leti o n

status of a student ’ s Free Application for Federal S t udent Aid (FAFSA) and facilitate providing assistance

to such stud e nts in co m

p l e ting the FAFSA, including both paid a n d n o n

- paid s t aff and auth o rized agents

such as contractors, subcontractors, vo l unteers, or o t her parties to whom the LEA, secondary school, or

Designated En ti t y has outsourced any of its services o r functions. All Authorized Personnel m u st be under

the direct control of the L E As, secondary schools, or Designated Enti t y with re s p ect to the u s e and

maintenance of ISIR Data.

Award Year: July 1 of one y ear through June 30 of the next y ear. For the Grant Services (Pell Grant, Iraq and

Afghanistan Servic e Gran t

, and TEACH Grant), and the eCB progr a m s s y st e ms, eligible students are paid

out of f unds designated for a particular award y ear.

Central Processing System (CPS): The CPS m anages the application and elig i b i li t y deter m ination portion of the

federal stud e nt aid process. It gathers information from applicants via the Free Application for Federal

Student Aid ( FAFSA), applies c o m puterized edits and calculations to deter m ine th e studen t ’s eligibili t y,

and com m

unicates the results to the stu d ents, schools, state agencies, third

- par t y servicers, and other

federal c o m

p uter s y ste m s.

Destination P o int: An organization enrolled in t h e SAIG that uses an electronic mailbox to s end and receive

financial aid data using the SAIG. Every Destination Point is ad m i nistered by a Pr i m ary or N on

- Pri m ary

Destination Point Ad m

inistrator (DPA) and has an electronic mailbox n u m b er t h at begins with the letters

“TG.”

Destination P o int Adminis t rator (DPA): An individu a l representing an organ i zation involved in the ad m ini s tra tion

of Title IV, HEA student financial aid programs (such as a postsec o ndary institution, a State Agency or

third

- par t y servicer) that is enrolled in the SAIG and a ssigned a De s tination Point. To enroll as a DPA, an organization’s representat i ve m u st c o mp lete and submit for processing the SAIG Enroll m ent Form to

participate in the U.S. Depart ment of Education’s S tu d ent Aid Int e rnet Gateway. The DPA is responsible

for the Agency ’ s SAIG users’ access to Federal Student Aid s y stems, to ensure the data provide d by these

s y stems is protected acco rd ing t o the P r ivacy Act of 1974, as a mended, as well as to ensure users do not

inappropriat e ly acce s s rec o rds that are not associated with their organization. The Pr i m ary DPA is

responsible for enrolling additional Non

- Pr i m ary DPAs for specif i c SAIG services. Non

- Primary DPAs are

not allowed to m ake S AIG enrol l me nt changes. An Agency may on l y ha v e one Primary DPA, but may

have many N on

- Pri m ary DPAs.

EDconnect: ED’s telec o m m unications software that allows PC Windows user s to send and r e ceive data through

the SAIG.

Electronic Servic e s: Primary Destination Po i n t A d ministrators ( P ri m ary DPAs) and their S econdary Destination

Point Ad m

inistrators (Sec o nda

r y DPAs) for their org a nization m ay enroll users for FAA Ac ce ss to CPS

O nline or EDconnect Entitle m ent Access. An FSA User ID and password are re q u ired to log in to both

s y stems.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: January 2014 State Grant Agency F o r m Pa g e 23 

### Attachment A: Glossa r y (Continued)

Electronic Servic e s U

s ers: Electronic Services Users are enrolled for FAA Access to CPS Online or EDconnect by

the Primary DPA. These users are ass o ciated with the Pr i m ary Destination Point and do not require

indiv i dual l y a ssigned mailboxes to access FAA Access or EDconnect. Th e y m u st read and sign a Federal

Student Aid User of Elec t ronic Services Stat e ment that the Prim a ry DPA m u st maintain.

Federa l Loan Servicer (Title IV Additional Servicer [ T IVA S ] or Not

- For

- Profit [NF

P ] ): An entity that services Title

IV, HEA loans owned by ED. These loans inc l ude, but are not li m ited to, William D. Fo rd Federal Direct

Loan (Direct Loan) Program loa n s and Feder a l Fa m ily Educ a tion Loan Program (FFELP) Purchased Loans.

Current listings of the Depar t m e nt's fede r al loan servicers, in cluding each service r 's contact infor m ation, are

available at the Loan S ervicing Centers for Schools and Loan S ervicer Centers for Stud ents pag e s on ED ’ s

Information for Fin a ncial Aid Professionals (IFAP) W e b site ( http:// i fap.ed.gov ).

Federal Stu d

ent Aid (FSA ) : The 19 9 8 R eauthorization of the Hi gh er Education Act (HEA) established a

performance

- based organization at the U.S. Depar t m e nt of Education to ad m inister the federal student

assis t ance progra m s authorized under Ti t le IV of the HEA. These programs include the Federal Pell Grant

Progra m

, the Iraq and Afghanistan Service Grant Progr a m

, the TEACH G r ant Progra m

, the F ederal

Supple menta l Educational Opportuni t y Grant Progra m

, the William D. Ford Federal Direct Loan Progr a ms,

the Federal Work Study Programs, and the Federal Perkins Loan Progra m

.

FAA Access to CPS Onlin e

. For p u rpos e s of this doc u ment, a Web tool that State Grant Agen c ies use to request

ISIRs. It is located at https://faaaccess

. ed.gov

. An FSA User I D is required to acc e ss stude n t infor m ation.

Free Application for Federal Student Aid (FAFSA): The application that the student m u st file to apply for aid from

any T itle IV, HE A progra m

. Students can apply on l ine by using FAFSA on th e Web ( http://fafsa.ed.gov ).

The FAFSA is also printed and distribut e d free of charge b y the U. S

. Depart m ent of Education.

Institutional Student I

n fo r mation Record (ISIR): The te r m ISIR re f ers to al l processed student infor m ation records

that are sent electronically t o institut i ons and state grant agencies by the CPS. The ISIR contains all

infor m ation reported on the Free Appli c ation for Federal Student Aid (FAFSA )

, k e y processing results, and

NSLDS financial aid history infor m ation.

National St ud ent Loan Da t a System (NSLDS): A national database of student lo an

- level information and selected

grant recipient data for loans and grants disbursed und e r the Title IV, HEA programs.

Non

- Primary Destination Point Admin i strator (Non

- Primary DPA): The Primary DPA is responsible for e n rolling

additional Non

- Primary DPAs for spec i fic SAIG s ervices a ssigned to the Non

- Pr i m ary DPA ’ s Destination

Points. Non

- Pr i m ary DPAs are not a llowed to make SAIG enrollment chan ges.

Non

- Resident: Title IV applicants who indicate on their FAFSA a post

- secondary institut i on t h at is located in the

state where the Agency is l o cated, but the Title IV applicant does not reside in a state other than the state

where the A g ency is locate d).OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: January 2014 State Grant Agency F o r m Pa g e 24 

### Attachment A: Glossa r y (Continued)

Primary D es t ination Point Administrator (Primary D PA): An ind i vidual who h as been designated b y the Agency as

the responsible party fo r the enrollment of the Agency’s addit i onal Non

- Pr i mary DPA’s which result in the

establishment of their SAIG Mailbo xes and may include FAA Acc e ss Onli n e use. The Pr i m ary DPA is

responsible for the SAIG users’ access to Federal Student Aid s y s te m s, to ensure that the data prov i ded to

and from these s y stems are protected according to t h e Privacy Act o f 197 4

, as amended, as well as to ensure

that users do not inappropriately a cce s s records that are not associated with their Agenc y

. Note: The

Primary DPA is resp o n sible for en r o lling additional Non

- Primary DPAs for specific SAIG services assigned

to the Non

- Pr i m a r y DPA ’ s De stination Point s

. The Pri m a r y DPA is ass i gned the pri m ary destination point.

Resident: Title IV applicants who indi c ate on their F AFSA, as t h eir state of legal residence, th e state in which the

Agency is lo c ated.

SAIG Mailbox. An electronic mailbox t h at is used to send and recei v e financial aid data using the SAIG. It is also

referred to as a Destination Point. (See Destination P o int .)

Social Security Number (SSN): The number assigned to an individual by the Social Security A d m inistration and

used as th e identif

y i ng nu m b er for m a n y Federal purp o ses, including identifying an SAIG participant and

applicants for the Title IV, HEA programs.

Student A i d I

n ternet Gateway (SAIG): The SAIG links thousands of Destination Points across the United States, its

terr itories, and certain ED

- designated foreign countr i e s to the High e r Education Act’s Title IV, HEA

student fina n cial aid prog r a m s and delivery s y ste m

. DPAs a r e a ss igned Destination Points (electronic

mailboxes), for receiving and trans m itt i ng data to v a

rious Title IV, HEA Federal Student Aid s y stems such

as NS L DS and CPS. (See Destination Po i n t and Destination Point Admin i strato r .)

TDClient: ED ’ s telec o m m uni c ations software that a llows Mainfr a m e/Midran g e users to se n d and receive data

throu g h the S AIG.

TG N umber : A TG N u m

b er is the identifier for an electron i c m ailbox which is referred to as a SAIG mailbox or

Destination Point. The TG Nu m b er is a fiv e

- digit alphanu m er i c nu m b er, prece d ed by “TG.”

Title IV, HEA student financial aid prog r ams: Student assist ance programs authorized by Title IV of the Higher

Education Act of 1 9 65, as a mended, (HEA).

U.S. Department of Educa t ion (ED, Depar t ment): The federal agency responsible for the administration of Title IV,

HEA Fe d eral student aid pr o g rams.OMB NO: 1845

- 0002

Expiration Date: 1/31/2 0 17

Effective Date: January 2014 State Grant Agency Fo r m Pa g e 25 

## Attachment B: Burden Statement

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a c o llection of

infor m ation unless it displa y s a valid OMB nu m ber. Public reporting burden for this collection of infor m a tion is

est i mated to average 40 m i nutes per init i al paper appl i cation response, 20 m inutes per initial web application online,

1 5 m i nutes per up d ated response on paper, a n d 10 m inutes per updated r esponse onli n e, including t i me for

reviewing instructions, searching existi n g data sour ces, gathering and m aintai n ing the data needed, and completing

and reviewing the collection of i n for m ation. T h e ob l igat i on to respond to t h is collection is required to obt a in or

retain a benefit. Send co m ments regard i ng the burden est i m a t e or any other asp ect of this col l ection of infor m ation,

including su g g estions for r educing this burden, t o the U.S. Department of Education, 4 0 0 M a r y la n d Ave., SW,

Washington, DC 20210

- 45 37 or e m ail I CDocketMgr@ed.gov a n d refer ence the OMB Control Nu m b er 1845

- 00 0 2.