Direct Loan Program EDA Application

What is Automatic Withdrawal of Payments?

Automatic withdrawal is a service that allows your bank to automatically debit your monthly student loan payments from your checking or savings account. Your payment will be forwarded from your bank to your servicer for processing.

What are the benefits?

Automatic withdrawal is the most convenient and efficient way to make your student loan payments. It saves you the time and inconvenience of writing and mailing a check every month, and ensures that your student loan payments will be made on time. In addition, if you pay by automatic withdrawal, you may be eligible to have your interest rate reduced by 0.25%!

How do I set up this service?

Complete the attached application by-

• Providing the requested information. (You may want to make a copy of the application for your records.)

• Writing the word "VOID" on a blank check or savings account deposit slip. Please do not submit a checking account deposit slip. Checking account deposit slips cannot be accepted because they often do not include all required information.

• Sending your application and voided blank check or savings account deposit slip to the address at the bottom of the application.

One application will cover all of your Direct Loans, and we will keep all of your information confidential.

How will I know if my application has been approved?

Your servicer will notify you in writing about the status of your application for automatic withdrawal of payments.

O n what day will my bank account be debited and for how much?

Y our servicer will notify you of your payment due date. Your account will be debited on that date. If the payment due date does not fall on a business day, your bank account will be debited on the following business day. The amount debited from your account will be the total monthly payment amount due for all of your Direct Loans.

What if I change my mind later and want to cancel this service?

To cancel automatic withdrawal and receive paper billing statements instead, contact your servicer at <Insert Servicer Phone>. Because it may take up to 30 days to discontinue automatic withdrawal of payments, one additional automatic payment may be debited from your bank account before you start receiving paper statements.

Where do I mail my application?

U.S. Department of Education

<Insert Servicer Name>

<Insert Servicer Processing Department>

<Insert Servicer Address>

<Insert Servicer Address>

Application for Automatic Withdrawal of Payments

Borrower's Name (Please Print)

- -

Student Loan Account Number

I authorize my bank to deduct my Direct Loan payments automatically from my checking or savings account each month. I agree that I may be charged a return item fee if the funds are not available at the time of the scheduled payment due date. By submitting this form, I agree to the terms and conditions stated above.

I understand that I must make regular payments until I am notified that my application has been approved. If at any time I decide to discontinue automatic withdrawal, I will notify my servicer by calling <Insert Servicer phone>.

Bank Account Type - Check One:

Checking

Savings

Purpose of this Application - Check One:

First Application

Change Banking Information

Bank Name:

Bank Phone Number:

Bank Routing Number:

Because the routing # on the bottom of your check or savings account deposit slip may be incomplete, please verify it with your bank before filling in the boxes.

Checking/Savings Account Number

Signature
	Holder of Bank Account

Date Signed

Here is an example of where you can find your 9-digit bank routing number and account number on your savings account deposit slip or your check.

Mail to this address:

U.S. Department of Education

<Insert Servicer Name>

<Insert Servicer Processing Department> <Insert Servicer Address>

<Insert Servicer Address>

	OMB No. 1845-0040 Form Approved Exp. Date xx/xx/xxxx
Privacy Act Notice The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you: The authority for collecting the requested information from and about you is §451 et seq. of the Higher Education Act (HEA) of 1965, as amended (20 U.S.C. 1087a et seq.) and the authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the William D. Ford Federal Direct Loan (Direct Loan) Program and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate. The principal purposes for collecting the information on this form, including your SSN, are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan (such as a deferment, forbearance, discharge, or forgiveness) under the Direct Loan Program, to permit the servicing of your loan(s), and, if it becomes necessary, to locate you and to collect and report on your loan(s) if your loan(s) become delinquent or in default. We also use your SSN as an account identifier and to permit you to access your account information electronically. The information in your file may be disclosed, on a case by case basis or under a computer matching program, to third parties as authorized under routine uses in the appropriate systems of records notices. The routine uses of this information include, but are not limited to, its disclosure to federal, state, or local agencies, to private parties such as relatives, present and former employers, business and personal associates, to consumer reporting agencies, to financial and educational institutions, and to guaranty agencies in order to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit the servicing or collection of your loan(s), to enforce the terms of the loan(s), to investigate possible fraud and to verify compliance with federal student financial aid program regulations, or to locate you if you become delinquent in your loan payments or if you default. To provide default rate calculations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to state agencies. To provide financial aid history information, disclosures may be made to educational institutions. To assist program administrators with tracking refunds and cancellations, disclosures may be made to guaranty agencies, to financial and educational institutions, or to federal or state agencies. To provide a standardized method for educational institutions to efficiently submit student enrollment status, disclosures may be made to guaranty agencies or to financial and educational institutions. To counsel you in repayment efforts, disclosures may be made to guaranty agencies, to financial and educational institutions, or to federal, state, or local agencies. In the event of litigation, we may send records to the Department of Justice, a court, adjudicative body, counsel, party, or witness if the disclosure is relevant and necessary to the litigation. If this information, either alone or with other information, indicates a potential violation of law, we may send it to the appropriate authority for action. We may send information to members of Congress if you ask them to help you with federal student aid questions. In circumstances involving employment complaints, grievances, or disciplinary actions, we may disclose relevant records to adjudicate or investigate the issues. If provided for by a collective bargaining agreement, we may disclose records to a labor organization recognized under 5 U.S.C. Chapter 71. Disclosures may be made to our contractors for the purpose of performing any programmatic function that requires disclosure of records. Before making any such disclosure, we will require the contractor to maintain Privacy Act safeguards. Disclosures may also be made to qualified researchers under Privacy Act safeguards.
Paperwork Reduction Notice According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average 0.0333 hours (2 minutes) per response, including the time for reviewing instruction ns, searching existing data resources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Individuals are obligated to respond to this collection to obtain a benefit in accordance with 34 CFR 685.211(b). Send comments regarding the burden estimate(s) or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Avenue, SW, Washington, DC, 20210-4537 or e-mail [email protected] and reference OMB Control Number 1845-0040. Note: Please do not return the completed Application for Automatic Withdrawal of Payments to this address. If you have questions about the status of your individual submission of this form, contact your servicer.
Automatic Payment Withdrawal Automatic Student Loan Payment System
Borrower Services Federal Student Aid U.S. Department of Education