Direct Loan Program Public Service Deferment Request (18

P UB

OMB No. 1845-0011

Draft Form

Exp. Date XX/XX/XXXX

PUBLIC SERVICE DEFERMENT REQUEST

William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family Education Loan (FFEL) Program

Direct Loan Program borrowers: Use this form only if you had an outstanding balance on a FFEL Program loan that was first disbursed before July 1, 1993 when you obtained your first Direct Loan.

FFEL Program borrowers: Use this form only if you have an outstanding balance on a FFEL Program loan that was first disbursed before July 1, 1993, or had a balance on a FFEL Program loan that was first disbursed before July 1, 1993 when you obtained a loan disbursed on or after July 1, 1993. Federal PLUS Loans that were first disbursed on or after August 15, 1983 and Federal Consolidation Loans do not qualify for these deferments.

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying document is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.

SECTION 1: BORROWER IDENTIFICATION

Please enter or correct the following information.

Check this box if any of your information has changed.

SSN

-

-

Name

Address

City, State, Zip Code

Telephone – Primary ( )

Telephone – Alternate ( )

E-mail Address (Optional)

SECTION 2: DEFERMENT REQUEST

Before completing this form, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7.

 I meet the eligibility requirements stated in Section 7 for the deferment checked below and request that my loan holder defer repayment of my loan(s) while I am:

On active duty in the ARMED FORCES of the United States and request that my loan holder limit by interest rate as applicable under the Servicemembers Civil Relief Act (SCRA).

• To obtain SCRA interest rate benefits, I will submit a copy of my military orders to my loan holder(s).

Serving full time as an officer in the Commissioned Corps of the PUBLIC HEALTH SERVICE.

Serving in the PEACE CORPS.

A full-time paid volunteer in the ACTION PROGRAMS.

A full-time paid volunteer for a TAX-EXEMPT ORGANIZATION.

On active duty in the NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION (NOAA).

• Direct Loan Program Loans: The NOAA Deferment is not available for Direct PLUS and Direct PLUS Consolidation Loans.

• FFEL Program Loans: The NOAA Deferment is available only to Federal Stafford and SLS loan borrowers whose first loans were first disbursed on or after July 1, 1987 and before July 1, 1993, or borrowers who had a balance on a loan that was first disbursed on or after July 1, 1987 and before July 1, 1993 when a loan was first disbursed on or after July 1, 1993.

SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION

 I understand that:

(1) I am not required to make payments of loan principal during my deferment. Interest will not accrue on my subsidized loan(s) during my deferment. However, interest will accrue on my unsubsidized loan(s).

(2) I may pay the interest that accrues on my unsubsidized loan(s) during my deferment. I may choose to make interest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period on my unsubsidized loan(s).

I wish to make interest payments on my unsubsidized loan(s) during my deferment.

(3) My deferment will begin on the date I began performing the public service that qualifies me for the deferment, as certified by the authorized official.

(4) My deferment will end on the earlier of the date that I stop performing the public service that qualifies me for the deferment, or the ending date of my qualifying public service, as certified by the authorized official. Maximum eligibility is years.

(5) If my deferment does not cover all my past due payments, my loan holder may grant a forbearance on my loan(s) for all payments due before the begin date of my deferment. If the period for which I am eligible for a deferment has ended, my loan holder may grant a forbearance on my loan(s) for all payments due when my deferment request is processed. Interest that accrues during this forbearance may be capitalized.

(6) My loan holder may grant a forbearance on my loan(s) for up to 60 days, if necessary, for the collection and processing of documentation related to my deferment request. Interest that accrues during this forbearance will not be capitalized.

 I certify that: (1) The information I have provided on this form is true and correct. (2) I will provide additional documentation to my loan holder, as required, to support my deferment status. (3) I will notify my loan holder immediately when the service that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility requirements of the deferment for which I have applied, as explained in Section 7.

 I authorize the entity to which I submit this request (i.e., the school, the lender, the guaranty agency, the U.S. Department of Education, and their respective agents and contractors) to contact me regarding my request or my loan(s), including repayment of my loan(s), at the number that I provide on this form or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded voice or text messages.

Borrower’s Signature

Date

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION

Note: As an alternative to completing this section, you may attach separate documentation from an authorized official that includes all of the information requested below or, for Armed Forces deferments, you may attach copies of the military identification and orders.

I certify, to the best of my knowledge and belief, that the borrower named above is/was engaged in the service indicated in Section 2, and that the borrower and the borrower’s service meet all the eligibility requirements specified in Section 7.

The borrower’s service began on |____|____|-|____|____|-|____|____|____|____| and is expected to end/ended on |____|____|-|____|____|-|____|____|____|____|.

Name of Organization

Address

City, State, Zip Code

Name/Title of Authorized Official

Telephone ( )

Authorized Official’s Signature

Date

SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM

Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: January 31, 2012 = 01-31-2012. An authorized official must either complete Section 4 or attach the organization’s own signed certification listing the required information. Include your name and account number on any documentation that you are required to submit with this form. If you need help completing this form, contact your loan holder. If you want to apply for a deferment on loans that are held by different loan holders, you must submit a separate deferment request to each loan holder.

Return the completed form and any required documentation to the address shown in Section 8.

SECTION 6: DEFINITIONS

 An authorized official who may complete Section 4 is your Commanding or Personnel Officer of the Armed Forces or an authorized official of the U.S. Public Health Service, Peace Corps, ACTION Programs, tax-exempt organization, or NOAA.

 Capitalization is the addition of unpaid interest to the principal balance of your loan. The principal balance of a loan increases when payments are postponed during periods of deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more payments may be required. The chart below provides estimates, for a $15,000 unsubsidized loan balance at a 6.8% interest rate, of the monthly payments due following a 12-month deferment that started when the loan entered repayment. It compares the effects of paying the interest as it accrues, capitalizing the interest at the end of the deferment, and capitalizing interest quarterly and at the end of the deferment. Please note that the U.S. Department of Education (the Department) and many other holders do not capitalize interest on a quarterly basis. The actual loan interest cost will depend on your interest rate, length of the deferment, and frequency of capitalization. Paying interest during the period of deferment lowers the monthly payment by about $12 and saves about $426 over the lifetime of the loan, as depicted in the chart below.

Treatment of Interest Accrued During Deferment	Loan Amount	Capitalized Interest for 12 Months	Principal to Be Repaid	Monthly Payment	Number of Payments	Total Amount Repaid	Total Interest Paid
Interest is paid	$15,000.00	$0.00	$15,000.00	$172.62	120	$21,736.55*	$6,730.66
Interest is capitalized at the end of deferment	$15,000.00	$1,022.09	$16,022.09	$184.38	120	$22,125.94	$7,119.64
Interest is capitalized quarterly during deferment and at the end of deferment	$15,000.00	$1,048.51	$16,048.51	$184.69	120	$22,162.41	$7,156.10

*Total amount repaid includes $1,022.09 of interest paid during the 12-month period of deferment.

 A deferment is a period during which you are entitled to postpone repayment of the principal balance of your loan(s). Interest does not accrue during a deferment on a Direct Subsidized Loan, a Direct Subsidized Consolidation Loan, a subsidized Federal Stafford Loan, or, in some cases, the subsidized portion of a Federal Consolidation Loan (see Note). Interest does accrue during a deferment on a Direct Unsubsidized Loan, a Direct PLUS Loan, a Direct Unsubsidized Consolidation Loan, an unsubsidized Federal Stafford Loan, a Federal PLUS Loan, or a Federal SLS Loan. Note: Interest does not accrue on a Federal Consolidation Loan during a deferment only if: (1) the application for the Federal Consolidation Loan was received by your loan holder on or after January 1, 1993, but before August 10, 1993; (2) the application was received by your loan holder on or after August 10, 1993, and the Federal Consolidation Loan includes only Federal Stafford Loans that were eligible for federal interest subsidy; or (3) the application was received by your loan holder on or after November 13, 1997, in which case interest does not accrue on the portion of the Federal Consolidation Loan that paid a subsidized Direct Loan or FFEL Program loan(s).

 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans, Federal PLUS Loans, Federal Consolidation Loans, and Federal Supplemental Loans for Students (SLS).

 A forbearance is a period during which you are permitted to temporarily postpone making payments, allowed an extension of time for making payments, or temporarily allowed to make smaller payments than scheduled.

 The holder of your Direct Loan Program loan(s) is the Department. The holder of your FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the Department.

 The William D. Ford Federal Direct Loan (Direct Loan) Program includes Federal Direct Stafford/Ford (Direct Subsidized) Loans, Federal Direct Unsubsidized Stafford/Ford (Direct Unsubsidized) Loans, Federal Direct PLUS (Direct PLUS) Loans, and Federal Direct Consolidation (Direct Consolidation) Loans.

SECTION 7: ELIGIBILITY REQUIREMENTS

 To qualify for any of the deferments listed in Section 2:

 For Direct Loan Program borrowers:

• You must have had an outstanding balance on a FFEL Program loan that was first disbursed before July 1, 1993 when you obtained your first Direct Loan.

• Direct PLUS and Direct PLUS Consolidation Loans are not eligible for the NOAA Deferment.

 For FFEL Program borrowers:

• You must have an outstanding balance on a FFEL Program loan that was first disbursed before July 1, 1993, or had a balance on a FFEL Program loan that was first disbursed before July 1, 1993 when you obtained a loan that was first disbursed on or after July 1, 1993.

• Federal Consolidation Loans are not eligible for these deferments.

• Federal PLUS Loans are not eligible for the NOAA Deferment and are only eligible for the other deferments listed in Section 2 if the Federal PLUS Loan was first disbursed before August 15, 1983.

• Your Federal Stafford and SLS Loan(s) are eligible for the NOAA Deferment only if your first FFEL Program loan was first disbursed on or after July 1, 1987 and before July 1, 1993, or you had an outstanding balance on a FFEL Program loan that was first disbursed on or after July 1, 1987 and before July 1, 1993 when you obtained a FFEL Program loan on or after July 1, 1993.

 You may defer repayment of my loan(s) while you are:

 On active duty in the ARMED FORCES of the United States. Maximum eligibility is 3 years. (This is a combined limit with Public Health Service and NOAA deferments.) To qualify, you must be on active duty in the Army, Navy, Air Force, Marine Corps, or Coast Guard.

Note: Borrowers enlisted in a reserve component of the Armed Forces or the National Guard (while on active duty status in the Army or Air Force Reserves) may qualify for this deferment only if: (1) serving full time for a period expected to last at least 1 year, or (2) serving under an order for national mobilization.

 Serving full time as an officer in the Commissioned Corps of the PUBLIC HEALTH SERVICE. Maximum eligibility is 3 years. (This is a combined limit with Armed Forces and NOAA deferments.)

 Serving in the PEACE CORPS. Maximum eligibility is 3 years. To qualify, you must have agreed to serve for a period of at least 1 year.

 A full-time, paid volunteer in the ACTION PROGRAMS. Maximum eligibility is 3 years. To qualify, you must have agreed to serve for a period of at least 1 year.

 A full-time paid volunteer for a TAX-EXEMPT ORGANIZATION. Maximum eligibility is 3 years. To qualify, you must:

(1) Be serving full time in an organization that has a tax exemption under Section 501(c)(3) of the Internal Revenue Code of 1986;

(2) Assist low income people and their communities in eliminating poverty and poverty-related human, social, and environmental conditions;

(3) Not earn more than the federal minimum wage; however, you may receive fringe benefits like those received by other employees of the organization;

(4) Not engage in religious instruction, proselytizing, fund-raising to support religious activities, or conduct worship services as part of your duties; and

(5) Have agreed to serve for a period of at least 1 year.

 On active duty in the NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION (NOAA). Maximum eligibility is 3 years. (This is a combined limit with Armed Forces and Public Health Service Deferments.)

SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST

Return the completed form and any required documentation to: (If no address is shown, return to your loan holder.)

If you need help completing this form, call: (If no telephone number is shown, call your loan holder.)

SECTION 9: IMPORTANT NOTICES

Privacy Act Notice. The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice be provided to you:

The authorities for collecting the requested information from and about you are §421 et seq. and §451 et seq. of the Higher Education Act of 1965, as amended (20 U.S.C. 1071 et seq. and 20 U.S.C. 1087a et seq.) and the authorities for collecting and using your Social Security Number (SSN) are §§428B(f) and 484(a)(4) of the HEA (20 U.S.C. 1078-2(f) and 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family Education Loan (FFEL) Program or 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 FFEL and/or Direct Loan Programs, 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) becomes delinquent or defaults. 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 statuses, 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 0.25ated to average 0.16 hours (10 hours (15 minutes) per response, including the time for reviewing instructions, searching existing data resources, gathering and maintaining the data needed, and completing and reviewing the information collection. Individuals are obligated to respond to this collection to obtain a benefit in accordance with 34 CFR 682.210 or 685.204. 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 1845-0011. Note: Please do not return the completed form to this address.

If you have questions regarding the status of your individual submission of this form, contact your loan holder (see Section 8).

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