Certificate of Agreement Page 1 of 4

1st & 2nd & 8thFloors,

Sagicor Sigma Building, Telephone: 876-754-2559
63-67 Knutsford Boulevard Facsimile: 876-754-2552
Kingston 5, Jamaica
E-mail: info@slbja.com

Certificate of Agreement for Coverage of Student Loan

Name of Borrower: Dushawn Medley TRN: 131216384

Address: Gordon Crescent Sex: Male
Granville P.O. D.O.B: December 16, 1999
St. James Institution: UWI, Mona

Purpose: The coverage offered under this Certificate of Agreement for Coverage is limited to the
settlement of the outstanding loan balances owed to the SLB during the loan
moratorium and the Loan repayment periods, excluding arrears; and covers the
borrower only in cases of:

1. Permanent disability - mental or physical;

2. Death;

Exceptions : i) Settlement of the outstanding debt will not apply if the death or permanent
disability of the insured resulted either directly or indirectly from any of the
following :

a) Suicide whether or not of sound mind;

b) Intentional self inflicted Injury;

c) Taking of any drug or any substance otherwise than under the direction
of a medical practitioner;

d) Committing or attempting to commit a violation of the law;

e) War declared or undeclared.

f) If the Eligibility Declaration attached is found to have been false at

the time of signing.
ii) The coverage offered by this agreement is limited to settling outstanding
balance on loans which are current as per loan agreement.

131216384 Dushawn Medley Tracking #:201906220509-131216384

Students' Loan Bureau - www.slbja.com - info@slbja.com Create Date: Saturday, June 22, 2019
Report Code: lpd_agrmnt_cert Revised date
Certificate of Agreement Page 2 of 4

Charge: 1. For the moratorium period the charge is $0.50 per

$1,000 on the amounts disbursed per academic year over
the moratorium period. Payment of charges for the
moratorium period is required in full prior to the loan
disbursement.
Please note that this charge is variable and is reviewed
annually.

2. For the repayment period the charge is $.50 per $1,000 on

the capitalized balance over the loan tenure.
Please note that this charge is variable and is reviewed
annually.

3. Coverage during the moratorium period shall be valid until

the 31st day of January of the year when loan repayment
commences. Payment of charges for the repayment period
shall be done monthly and shall form a part of the expected
monthly repayment installments.

4. A grace period of fifteen (15) days will be allowed for the

payment of charges due hereunder. In the event that the
charges described herein are not paid within the
aforementioned said grace period, the said coverage will cease
at expiration of grace period, and demand will be made for
the full payment of the loan.

FOR OFFICIAL USE ONLY

Moratorium Coverage Coverage for Remaining Loan Tenure

(period of study) (repayment period)

Date of Origination: 2019 Coverage ________________

Period of Cover: 65 months Commencement Date: ________________

Expiry Date: January 31, 2025 Scheduled expiration date ________________

Coverage Amount: $1,000,000.00 Charge: $0.50 /1000 per repayment period

Premiums Paid: $32,500.00 (Note that this amount is variable)

N.B This document supersedes all previous Agreements for Coverage of the Student Loan(s) and covers
all loans in moratorium and in repayment.

131216384 Dushawn Medley Tracking #:201906220509-131216384

Students' Loan Bureau - www.slbja.com - info@slbja.com Create Date: Saturday, June 22, 2019
Report Code: lpd_agrmnt_cert Revised date
Certificate of Agreement Page 3 of 4

Declaration of Eligibility

To the best of my knowledge and belief, during the past two years I have not been treated for, diagnosed, nor
have I been advised to have treatment for any of the following:

. Acquired Immune Deficiency Syndrome (AIDS);

. cancer or tumor;
. diabetes;
. any disease of the heart, lungs, circulatory system, kidneys or liver;
. any other terminal , mental, physical or disabling illness;
. I have not been confined in hospital or other medical institution during the preceding six (6) months.
. I am not receiving nor have I applied for any benefits from any governmental or other disability plan for
any disability arising from any of the above diseases or conditions.

I understand that to be eligible for coverage of the student loan, the foregoing representations must be true to
the best of my knowledge and shall, in the absence of fraud, be deemed representations and not warranties,
and if the representations made herein are found not to be true, that I am not eligible for insurance coverage
for which application is made and the Students’ Loan Bureau has no liability under this agreement. In the
event of a claim under this certificate, I hereby authorize my attending physician and/or hospital to disclose to
the Students’ Loan Bureau all my relevant medical history and records prior to and subsequent to the date of
this agreement.

I accept that the payment of my insurance is compulsory and intended to protect my interest as well as that
of my Guarantors.

Application of Excess Insurance Premiums

I also hereby give the Students’ Loan Bureau permission to apply any excess insurance premiums paid by me,
towards the reduction of my Loan Principal.

DATED THE DAY OF 20

Borrower’s Name _________________ Borrower's Signature _________________

( if beneficiary if under 18 years)

Guardian's Name _________________ Guardian's Signature _________________

Witness’s Name __________________ Witness’s Signature __________________

(SLB Representative /
Justice of the Peace / Attorney Or Medical Doctor Only)
N.B This document is to be executed by a Guardian if the beneficiary is under the age of 18 years.

N.B This document is to be executed by a Guardian if the beneficiary is under the age of 18 years.

131216384 Dushawn Medley Tracking #:201906220509-131216384

Students' Loan Bureau - www.slbja.com - info@slbja.com Create Date: Saturday, June 22, 2019
Report Code: lpd_agrmnt_cert Revised date
Certificate of Agreement Page 4 of 4

CONDITIONS OF ACCESS TO COVERAGE

Proof of Death

Upon the death of the beneficiary, the guarantors or family members must furnish proof (death certificate)
to the Students’ Loan Bureau.

Permanent Disability Provision

By definition the term permanent disability shall mean a state of bodily or mental incapacity resulting from
disease or injury such that the borrower is thereby wholly prevented from engaging in any part of the duties
of any occupation or from performing any work whatsoever for remuneration or profit on a permanent
basis.

Proof of Disability

While this disability provision is in full force, proof satisfactory to SLB shall be submitted that the borrower
has, as a result of injury or disease commencing after this disability provision took effect, become
permanently disabled for a period of no less than six (6) consecutive months, then, except as hereafter
provided, a portion of the pool will be used to settle the beneficiary's loan account in full.

Proof of Continuance

At any time the SLB may demand proof, satisfactory to it, of the continuance of permanent disability, and if
such proof is not furnished, the borrower shall be deemed to have ceased to be permanently disabled prior
to the date on which such demand was made and, on the sole discretion of the SLB must
commence/resume the payment of the loan under the same terms and conditions prior to him/her
becoming totally disabled.

Claim Requirements

A portion of the coverage will be used to retire the debt upon the death or permanent disability of the
beneficiary only under the following conditions:
a) the coverage is paid in full
b) the account is current

131216384 Dushawn Medley Tracking #:201906220509-131216384

Students' Loan Bureau - www.slbja.com - info@slbja.com Create Date: Saturday, June 22, 2019
Report Code: lpd_agrmnt_cert Revised date