Toledo Bar Association Foundation

Toledo Bar Association Foundation

TOLEDO BAR ASSOCIATION FOUNDATION

LAWYERS IN NEED PROGRAM

Personal Hardship Loan Package

1.Loan Application

2.Eligibility for Personal Hardship Loans

3.Financial Disclosure Form

4.Schedule of LAWO Income and Eligibility Guidelines

5.Promissory Note Form

You should review the Eligibility Guidelines and complete the Loan Application and Financial Disclosure Form.

LOAN APPLICATION

Date:

Loan Applicant’s Name:

Home/Office Address:

Loan amount requested:

Purpose of Loan:

Briefly describe the event and/or circumstances which have caused your desperate financial need:

Do you have insurance and/or other resources available to help with this situation? Yes No

If yes, please explain (be sure to indicate if you have made an insurance claim):

You must exhaust insurance and any other resources before you can apply for a loan under this program.

Foundation use only:

1.Has the applicant met all eligibility requirements? Yes No

2.Is the applicant an attorney in good standing? Yes No

3.County of office/home?

4.Is the applicant or a member of his/her household the cause of the need? Yes No

5.Does the purpose for the loan meet eligibility guidelines? Yes No

6.Are the applicant’s assets and income within the LAWO Income and Eligibility Guidelines? Yes No

7.Date loan approved by Foundation Board:

8.Amount of approved loan (may not exceed $10,000):

9.Date Promissory Note was signed:

10.Date check for loan was issued:

11.How was loan check delivered to applicant?

12.Are there any unpaid Foundation Loans to this Applicant? Yes No

13.What is the applicable interest rate for short-term loans compounded monthly?

(go to: and select the month the loan is made)

PROMISSORY NOTE

$______Date: ______

FOR VALUE RECEIVED, the undersigned, (the "Maker"), hereby promises to pay to the order of TOLEDO BAR ASSOCIATION FOUNDATION ("Payee"), the principal sum of $______plus interest pursuant to the terms and conditions of this Promissory Note.

PAYMENT OF PRINCIPAL. The principal amount of this Promissory Note (the "Note") and any accrued but unpaid interest shall be due and payable as and when Maker is able to make payments. All payments under this Note shall be applied first to accrued but unpaid interest, and next to outstanding principal.

INTEREST. This note:

Shall bear interest compounded annually at ______% (annual interest rate)

Shall not bear interest (principal is less than $10,000)

GOVERNING LAW. This Note shall be governed by, and construed in accordance with, the laws of the State of Ohio.

SUCCESSORS. All of the foregoing is the promise of Maker and shall bind Maker and Maker's successors, heirs and assigns; provided, however, that Maker may not assign any of its rights or delegate any of its obligations hereunder without the prior written consent of the holder of this Note.

IN WITNESS WHEREOF, Maker has executed this Promissory Note as of the day and year first above written.

MAKER:

Signature

Print Name

REPAYMENT SCHEDULE

Date / Name of Payer / Amount Paid

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