LOAN REPAYMENT AGREEMENT

In consideration of the receipt of an educational loan from the Board of Medical Scholarship Awards, I, _______________________________ agree to establish or work for a medical practice in the city/town of ___________________________________, Alabama for the periods specified in Section 16-47-126, Code of Alabama 1975. I understand that the designation of practice location may be changed by me up to the date of completion of my residency training program, subject to the approval of the intended practice location as medically underserved area by the Board of Medical Scholarship Awards. I further understand that failure to complete the practice repayment obligations may require repayment of the principle amount of the loan plus interest and penalties as established by Section 34-47-127, Code of Alabama 1975.

______________________________ ______________________________

Signature of Loan Recipient     Printed Name of Loan Recipient

___________________________________

Date

The practice area designated above has been approved by the Board of Medical Scholarship Awards or the Executive Committee as a medically underserved area under the provisions of Section 16-47-126, Code of Alabama 1975.

_________________________________________

Chairman of the Board or Executive Committee

_________________________________________

Date

Author: Wayne P. Turner

Statutory Authority: Code of Ala. 1975, §§16-47-121 et seq.; 41-22-1 et seq.

History: New Appendix: Filed May 16, 2006; effective June 20, 2006. Amended: Published September 29, 2023; effective November 13, 2023.