FFEL IBR Plan Request and Alternate Documentation of Inc

IDR

INCOME-DRIVEN REPAYMENT PLAN REQUEST:

Income-Based Repayment (IBR), Pay As You Earn, and Income-Contingent Repayment (ICR) plans for the William D. Ford Federal Direct Loan (Direct Loan) Program and Federal Family Education Loan (FFEL) Program

OMB No. 1845-0102

Form Approved

Exp. Date 11/30/2015

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

Telephone – Primary

Telephone – Alternate

E-mail (optional)

___ ___ ___ - ___ ___ - ___ ___ ___ ___

____________________________________

____________________________________

____________________________________

( _______ ) _______ - _____________

( _______ ) _______ - _____________

____________________________________

SECTION 2: REPAYMENT PLAN OR RECERTIFICATION REQUEST

Before completing this form, carefully read the entire form. Return the completed form and any required documentation to the address shown in Section 7. You may be able to complete your request online by visiting StudentLoans.gov.

Other repayment plans may be available and may offer a lower monthly payment amount. You may pay more interest over time under an income-driven plan and may have to pay federal income tax on any loan amount forgiven under an income-driven plan. A calculator is available at StudentAid.gov/repayment-estimator to estimate your payment amount under all available repayment plans.

1. Please select the reason that you are completing this request by checking box a, b, or c, below.

   1. I am requesting a repayment plan based on my income – Check the plan(s) you are requesting below and then continue to item 2.

Income-Driven Repayment Plan	Direct Loan Program Loans	FFEL Program Loans
IBR
Pay As You Earn		Not Available
ICR		Not Available
I request that my loan holder determine which of the above plans I am eligible for, and place me on the plan with the lowest monthly payment amount.	Only IBR is available for FFEL Program loans

Your request will apply to all of your loans that are eligible for the plan you choose. You will need to choose a different repayment plan for loans that are not eligible for an income-driven repayment plan (see section 9) or those loans will be placed on the standard repayment plan.

2. I am submitting annual documentation for the recalculation of my monthly payment amount under my current repayment plan – Continue to item 2.

3. I am requesting that my loan holder recalculate my current monthly payment amount because my circumstances have changed – Continue to item 2.

1. Check this box if you owe eligible loans to more than one loan holder. You must submit a separate request to each holder of the loans you want to repay under the IBR, Pay As You Earn, or ICR plan.

You must promptly submit to your loan holder this completed form and a copy of your most recent federal income tax return or federal income tax return transcript (see Section 4), or, if applicable, alternative documentation of your current income (see Section 5).

SECTION 3: SPOUSAL INFORMATION

Complete this section if any of the following apply to you:

• You file a joint federal income tax return with your spouse and your spouse has eligible loans.

• You have a joint Direct or FFEL Consolidation Loan that you obtained with your spouse as a co-borrower.

• You and your spouse have Direct Loans and both of you want to repay those loans under the ICR Plan.

3. Spouse’s SSN ___ ___ ___ - ___ ___ - ___ ___ ___ ___

4. Spouse’s Name ______________________________________

5. Spouse’s Date of Birth ___ ___ - ___ ___ - ___ ___ ___ ___

6. My spouse and I want to repay our Direct Loans jointly under the ICR Plan.

If you complete this section, your spouse must also sign this form. By signing, your spouse is authorizing your loan holder to access information about his or her federal student loans in the National Student Loan Data System (NSLDS). If your spouse has FFEL Program loans that are not held by your loan holder, your spouse will need to give your loan holder access to his or her loan information in NSLDS (nslds.ed.gov). For more information, contact your loan holder.

SECTION 4: FAMILY SIZE AND FEDERAL TAX INFORMATION

7. ___ ___ Enter your family size (see Section 9; if you leave this blank, your loan holder will use a family size of one).

8. Did you file a federal income tax return in either of the two most recently completed tax years?

Yes – Continue to Item 9.

No – Skip to Section 5.

9. Is your current income or your spouse’s current income (if you completed Section 3 or if you file a joint federal income tax return) significantly different than the income reported on your most recent federal income tax return?

Yes – Continue to Section 5.

No – Provide your most recent federal income tax return or transcript. Skip to Section 6.

SECTION 5: ALTERNATIVE DOCUMENTATION OF INCOME

Complete this section if you (1) answered “No” to Question 8, (2) answered “Yes” to Question 9, or (3) if your loan holder requires you to provide alternative documentation of income.

10. Do you currently have taxable income? Check “No” if you do not have any income or receive only untaxed income.

Yes – Provide documentation of this income, as described below.

No – By signing this form, you are certifying that you do not have any taxable income.

11. If you completed Section 3 or file a joint federal income tax return with your spouse, does your spouse currently have taxable income? Check “no” if your spouse does not have any income or receives only untaxed.

Yes – Provide documentation of your spouse’s income, as described below.

No – By signing this form, your spouse is certifying that he/she does not have any taxable income.

If you answered “Yes” to Items 10 or 11, below are instructions on how to document your income:

You must provide documentation of all taxable income that you and your spouse (if applicable) currently receive (for example, income from employment, unemployment income, dividend income, interest income, tips, alimony). Do not report untaxed income such as Supplemental Security Income, child support, or federal or state public assistance.

You must provide one piece of documentation for each source of taxable income. Documentation may include a pay stub, a letter from your employer listing pay, bank statements, or dividend statements. If documentation is unavailable, attach a signed statement explaining the income source(s) and giving the name and the address of the income source(s).

Unless the frequency is clearly indicated on the documentation that you provide, write on your documentation how often you receive the income, for example, “twice per month” or “every other week”. The date on any supporting documentation you provide must be no older than 90 days from the date you sign this form. Copies of original documentation are acceptable.

SECTION 6: BORROWER REQUEST UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION

• I request to use the plan I selected in Section 2 to repay my eligible Direct Loan or FFEL Program loans held by the holder to which I submit this form. If I selected the option to allow my loan holder to choose my plan, I request my loan holder place me in the plan with the lowest monthly payment amount. If more than one plan provides the same initial payment amount, I understand that my loan holder will choose the plan that is likely to keep my monthly payment amount lower in subsequent years or provides terms and conditions that better limit the total cost of my loans. If I select a plan for which I do not qualify, I request that my loan holder determine which of the income-driven plans I am eligible for, and place me on the plan with the lowest monthly payment amount.

• I understand that:

1. If I am entering repayment on my loan for the first time and do not provide my loan holder with this completed form and any other documentation required by my loan holder, or if I do not qualify for the repayment plan that I requested, I will be placed on the standard repayment plan (see Section 9).

2. If I am currently repaying my loan under a different repayment plan and want to change to the repayment plan I selected in Section 2, my loan holder may grant me a forbearance for up to 60 days to collect and process documentation supporting my request for the selected plan. I am not required to make loan payments during this period of forbearance, but interest will continue to accrue. Unpaid interest that accrues during this forbearance period will not be capitalized (see Section 9).

3. If I am in a deferment or forbearance at the time I request one of the repayment plans listed in Section 2, my loan holder may end the deferment or forbearance early to process my new repayment plan request.

4. If I am delinquent in making payments under my current repayment plan at the time I request one of the repayment plans listed in Section 2, my loan holder may grant me a forbearance to cover any payments that are overdue, or that would be due, at the time my request is processed. Unpaid interest that accrues during this forbearance period may be capitalized.

5. If I am requesting the ICR plan, my initial payment amount will be the amount of interest that accrues each month on my loan until my loan holder receives the income documentation needed to calculate my ICR payment amount. If I cannot afford the initial interest payments, I may request forbearance by contacting my loan holder.

• I authorize the loan holder to which I submit this request (and its agents or 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.

• I certify that all of the information I have provided on this form and in any accompanying documentation is true, complete, and correct to the best of my knowledge and belief.

Borrower Signature _______________________________________________ Date ___ ___ - ___ ___ - ___ ___ ___ ___

Spouse’s Signature (if required) _____________________________________ Date ___ ___ - ___ ___ - ___ ___ ___ ___

Note: Your spouse’s signature is required if you completed Section 3 and/or completed Item 11.

SECTION 7: WHERE TO SEND THE COMPLETED REQUEST

Return the completed form and any required documentation to:

(If no address is shown, return to your loan servicer.)

If you need help completing this form, call:

(If no telephone number is shown, call your loan servicer.)

SECTION 8: 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, 2014 = 02-14-2014. 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 repayment plan on loans that are held by different loan holders, you must submit a separate request to each loan holder.

Return the completed form and any required documentation to the address shown in Section 7.

SECTION 9: DEFINITIONS

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

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

• The Income-Based Repayment (IBR) plan is a repayment plan with monthly payments that are limited to 15% (10% if you are a new borrower) of your discretionary income, divided by 12.

• Discretionary income for this plan is the amount by which your adjusted gross income exceeds 150% of the poverty guideline amount for your state of residence and family size. To initially qualify for IBR and to continue making income-based payments under this plan, you must have a partial financial hardship (see definition).

• Eligible loans for the IBR plan are Direct Loan and FFEL Program loans other than: (1) a loan that is in default, (2) a Direct or Federal PLUS Loan made to a parent borrower, or (3) a Direct or Federal Consolidation Loan that repaid a Direct or Federal PLUS Loan made to a parent borrower. Federal Perkins Loans, HEAL loans or other health education loans, and private education loans are not eligible to be repaid under the IBR plan.

• You are a new borrower for the IBR plan if (1) you have no outstanding balance on a Direct Loan or FFEL Program loan as of July 1, 2014 or have no outstanding balance on a Direct Loan or FFEL Program loan when you obtain a new loan on or after July 1, 2014.

• The Pay As You Earn plan is a repayment plan with monthly payments that are limited to 10% of your discretionary income, divided by 12.

• Discretionary income for this plan is the amount by which your adjusted gross income exceeds 150% of the poverty guideline amount for your state of residence and family size. To initially qualify for the Pay As You Earn plan and to continue to make income-based payments under this plan, you must have a partial financial hardship (see definition) and be a new borrower (see definition).

• Eligible loans for the Pay As You Earn plan are Direct Loan Program loans received by a new borrower other than: (1) a loan that is in default, (2) a Direct PLUS Loan made to a parent borrower, or (3) a Direct Consolidation Loan that repaid a Direct or Federal PLUS Loan made to a parent borrower. FFEL Program Loans, Federal Perkins Loans, HEAL loans or other health education loans, and private education loans are not eligible to be repaid under the Pay As You Earn plan.

• You are a new borrower for the Pay As You Earn plan if: (1) you have no outstanding balance on a Direct Loan or FFEL Program loan as of October 1, 2007 or have no outstanding balance on a Direct Loan or FFEL Program loan when you obtain a new loan on or after October 1, 2007, and (2) you receive a disbursement of a Direct Subsidized Loan, Direct Unsubsidized Loan, or a Direct PLUS Loan made to a student borrower on or after October 1, 2011, or you receive a Direct Consolidation Loan based on an application received on or after October 1, 2011. However, you are not considered a new borrower if the Direct Consolidation Loan you receive repays loans that would make you ineligible under part (1) of this definition.

• The Income-Contingent Repayment (ICR) plan is a repayment plan with monthly payments that are the lesser of (1) what you would pay on a 12-year standard repayment plan multiplied by an income percentage factor or (2) 20% of your discretionary income divided by 12.

• Discretionary income for this plan is the amount by which your adjusted gross income exceeds the poverty guideline amount for your state of residence and family size.

• Eligible loans for the ICR plan are Direct Loan Program loans other than: (1) a loan that is in default, (2) a Direct PLUS Loan made to a parent borrower, or (3) a Direct PLUS Consolidation Loan (these are Direct Consolidation Loans made based on an application received prior to July 1, 2006 that repaid Direct or Federal PLUS Loans made to a parent borrower). FFEL Program Loans, Federal Perkins Loans, HEAL loans or other health education loans, and private education loans are not eligible to be repaid under the ICR plan. A Direct Consolidation Loan made based on an application received on or after July 1, 2006 that repaid a Direct or Federal PLUS Loan made to a parent borrower, is eligible for the ICR plan.

• A partial financial hardship is an eligibility requirement for the IBR and Pay As You Earn plans.

• You have a partial financial hardship when the annual amount due on all of your eligible loans or, if you are married and file a joint federal income tax return, the annual amount due on all of your eligible loans and your spouse’s eligible loans, exceeds 10% (for the Pay As You Earn plan and for new borrowers under the IBR plan) or 15% of the amount by which your adjusted gross income (AGI) exceeds 150% of the annual poverty guideline amount for your family size and state of residence.

• For both the IBR and Pay As You Earn plans, the annual amount of payments due is calculated based on the greater of (1) the total amount owed on eligible loans at the time those loans initially entered repayment, or (2) the total amount owed on eligible loans at the time you initially request the IBR or Pay As You Earn plan. The annual amount of payments due is calculated using a standard repayment plan with a 10-year repayment period, regardless of loan type.

• If you are married and file a joint federal income tax return, your AGI includes your spouse’s income.The poverty guideline amount is the figure for your state and family size from the poverty guidelines published annually by the U.S. Department of Health and Human Services (HHS). The HHS poverty guidelines are used for purposes such as determining eligibility for certain federal benefit programs. If you are not a resident of a state identified in the poverty guidelines, your poverty guideline amount is the amount used for the 48 contiguous states.

• Family size includes you, your spouse, and your children (including unborn children who will be born during the year for which you certify your family size), if the children will receive more than half their support from you. It includes other people only if they live with you now, they receive more than half their support from you now, and they will continue to receive this support from you for the year that you certify your family size. Support includes money, gifts, loans, housing, food, clothes, car, medical and dental care, and payment of college costs. For the purposes of these repayment plans, your family size may be different from the number of exemptions you claim on your federal income tax return.

• Capitalization is the addition of unpaid interest to the principal balance of your loan. This will increase the principal balance and the total cost of your loan.

• The holder of your Direct Loans is the U.S. Department of Education (the Department). The holder(s) of your FFEL Program loan(s) may be a lender, secondary market, guaranty agency, or the Department. Your loan holder(s) may use a servicer to handle billing, payment, repayment options, and other communications on your loans. References to “your loan holder” on this form mean either your loan holder(s) or your servicer.

• The standard repayment plan has a fixed monthly payment amount over a repayment period of up to 10 years for loans other than Direct or Federal Consolidation Loans, or up to 30 years for Direct and Federal Consolidation Loans.

SECTION 10: ELIGIBILITY REQUIREMENTS

INFORMATION ABOUT THE IBR AND PAY AS YOU EARN PLANS:

• To initially qualify to repay your loan under the IBR or Pay As You Earn plan and to continue to qualify to make payments based on your income, you must have a partial financial hardship (as defined in Section 9). If you are married and file a joint federal income tax return, your loan holder will also take your spouse’s income and eligible loans into account when determining whether you have a partial financial hardship.

• For the Pay As You Earn plan, you must be a new borrower as defined in Section 9.

• Although the Pay As You Earn plan is available only for Direct Loan Program loans, the Department will take any FFEL Program loans that you have into account when determining whether you have a partial financial hardship except for: (1) a FFEL Program loan that is in default, (2) a Federal PLUS Loan made to a parent borrower, or (3) a Federal Consolidation Loan that repaid a Federal or Direct PLUS Loan made to a parent borrower.

• After entry into the IBR or Pay As You Earn plan, you must annually certify your family size and provide income documentation for determination of whether you continue to have a partial financial hardship. Your loan holder will notify you of the deadline by which you must provide this documentation. Your monthly payment amount may be adjusted annually. The new payment amount may be higher or lower, depending on the income documentation and family size information you provide each year.

• If you do not provide updated income documentation annually, within 10 days of the deadline provided by your loan holder, after requested to do so by your loan holder, your payment amount will be the 10-year standard payment amount calculated at the time that you initially entered the IBR or Pay As You Earn plan and any outstanding interest will be capitalized (added to your principal balance).

• You will never pay more per month under the IBR or Pay As You Earn plan than you would on the 10-year standard repayment plan, based upon the amount owed on your eligible loans at the time you initially entered the IBR or Pay As You Earn plan.

• Under the IBR or Pay As You Earn plan, your monthly payment may be less than the monthly accruing interest. On subsidized loans, you are not required to pay any monthly accrued interest that exceeds your monthly payment amount for a maximum of three consecutive years from the date that you start repaying your loans under the IBR or Pay As You Earn plan. The three-year consecutive period limit does not include any period during which you receive an economic hardship deferment. On unsubsidized loans, all accruing interest is your responsibility.

• If you are determined to no longer have a partial financial hardship or you leave the IBR or Pay As You Earn plan, any unpaid interest will be capitalized (added to your principal balance). However, if you are in the Pay As You Earn plan and are determined to no longer have a partial financial hardship, the amount that is capitalized is limited to 10% of the outstanding principal balance on your loans at the time that you entered the Pay As You Earn plan.

• If you leave the IBR plan, you will be placed on the standard repayment plan and your monthly payment amount will be calculated based on the outstanding balance of your eligible loans at the time you leave the IBR plan and the repayment period remaining for your loans. If you wish to repay your loans under a different repayment plan, you must first make one payment under the standard repayment plan or make a reduced payment under a forbearance agreement with your loan holder while you are on the standard repayment plan.

• If you leave the Pay As You Earn Plan, you may change to any other repayment plan for which you qualify.

• Under the IBR and Pay As You Earn plans, if your loan is not repaid in full after you have made the equivalent of 20 years (for the Pay As You Earn plan and for new borrowers under the IBR plan) or 25 years (for all other borrowers under the IBR plan) of qualifying monthly payments and that many years have elapsed, any remaining debt will be forgiven. If you receive an economic hardship deferment, any months of economic hardship deferment are considered the equivalent of qualifying payments. Months for which you receive any other type of deferment or months of forbearance are not counted as qualifying payments, and do not count toward the 20- or 25-year forgiveness period. Any amount forgiven under the IBR plan or Pay As You Earn plan may be considered income by the Internal Revenue Service and subject to federal income tax.

SECTION 10: ELIGIBILITY REQUIREMENTS (CONTINUED)

INFORMATION ABOUT THE ICR PLAN:

• All Direct Loan borrowers are eligible to repay their eligible loans on the ICR plan. You are not required to have a partial financial hardship to use the ICR plan. To repay eligible loans under the ICR plan, you must submit documentation of your income. If you are married and file a joint federal tax return, the Department will also take your spouse’s income into account when calculating your monthly payment amount.

• If you are married, you and your spouse may choose to repay your loans jointly under the ICR plan. If you choose to repay jointly, the Department will use your combined income and Direct Loan debt to calculate a joint ICR payment amount, and will then prorate the joint payment amount to determine separate ICR monthly payment amounts for you and your spouse that are proportionate to each individual’s share of the combined Direct Loan debt. You and your spouse may select this option under the ICR plan regardless of your federal tax return filing status.

• After entry into the ICR plan, you must annually certify your family size and provide income documentation so that the Department can adjust your payment amount to reflect more recent income information. Your new payment amount may be higher or lower, depending on the income documentation and family size information you provide each year. The Department will notify you when you must provide this documentation.

• If you do not provide updated income documentation annually by the deadline provided by the Department, your payment amount will be calculated based on a 10-year standard repayment plan using the loan balance at the time you entered repayment under the ICR repayment plan.

• Under the ICR plan, your monthly payment may be less than the monthly accruing interest. The accruing interest that is not satisfied by your monthly payment will be capitalized annually. You will receive a notice telling you when the interest will be capitalized, and you will have the opportunity to pay that interest before it is capitalized. While you remain in ICR, the amount of interest that is capitalized will be limited to 10% of the outstanding principal balance on your loans at the time that you entered repayment.

• Under the ICR plan, if your loan is not repaid in full after you have made the equivalent of 25 years of qualifying monthly payments and at least 25 years have elapsed, any remaining debt will be forgiven. If you receive an economic hardship deferment, any months of economic hardship deferment are considered the equivalent of qualifying payments. Months for which you receive any other type of deferment or months of forbearance are not counted as qualifying payments, and do not count toward the 25-year forgiveness period. Any amount forgiven under the ICR plan may be considered income by the Internal Revenue Service and subject to federal income tax.

IMPORTANT INFORMATION ABOUT ALTERNATIVE DOCUMENTATION OF INCOME

• YOU ARE REQUIRED to provide alternative documentation of your income if:

• You did not file a federal tax return for either of the two most recently completed tax years; or

• You have been notified by your loan holder(s) that alternative documentation of your income is required.

• YOU MAY provide alternative documentation of your income if your Adjusted Gross Income (AGI), as reported on your most recently filed federal tax return, does not reasonably reflect your current income, for example, because of a loss of or change in employment by you or your spouse.

• YOU ARE NOT REQUIRED to provide alternative documentation of your income if you can provide a copy of your most recently filed federal tax return or an IRS tax return transcript from either of the two most recently completed tax years; and that documentation reasonably reflects your current income.

IMPORTANT INFORMATION ABOUT PUBLIC SERVICE LOAN FORGIVENESS (PSLF)

• The Public Service Loan Forgiveness Program allows eligible borrowers to cancel the remaining balance of their Direct Loans after they have served full time at a qualifying employer for at least 10 years, while making 120 qualifying loan payments, including payments under the IBR, Pay As You Earn, and ICR plan.

• Qualifying employers include governmental organizations and many not-for-profit organizations.

• For more information about PSLF, see StudentAid.gov/PublicService.

SECTION 11: SAMPLE PAYMENT AMOUNTS

Below are two tables that provide examples of monthly and total payment amounts under the Standard, Graduated, and Extended repayment plans. These figures are estimates, and use an interest rate of 8.25%. Various factors, including your actual interest rate and the amount of your loan debt, may cause your payment amount to differ from the payment amounts shown in these tables. Your loan holder will provide you with the actual monthly payment amount after you select a repayment plan.

Table 1. Sample Payment Amounts Under the Standard, Graduated, Extended-Fixed, and Extended-Graduated Plans for Direct and FFEL Subsidized, Unsubsidized, and PLUS Loans

Debt	Standard (10 years)		Graduated (10 years)			Extended-Fixed (25 years)		Extended-Graduated (25 years)
	Payment	Total Paid	Minimum Payment	Maximum Payment	Total Paid	Payment	Total Paid	Minimum Payment	Maximum Payment	Total Paid
$20,000	$245	$29,437	$144	$431	$32,177	Not Eligible	-	Not Eligible	-	-
$30,000	$368	$44,155	$216	$647	$48,265	Not Eligible	-	Not Eligible	-	-
$40,000	$491	$58,873	$287	$862	$64,353	$315	$94,614	$275	$417	$101,515
$50,000	$613	$73,592	$359	$1,078	$80,442	$394	$118,268	$344	$521	$126,899
$60,000	$736	$88,310	$431	$1,294	$96,530	$473	$141,921	$413	$625	$152,280
$70,000	$859	$103,028	$503	$1,509	$112,618	$552	$165,575	$481	$730	$177,664
$80,000	$981	$117,747	$575	$1,725	$128,706	$631	$189,228	$550	$834	$203,046
$90,000	$1,104	$132,465	$647	$1,940	$144,795	$710	$212,882	$619	$938	$228,427

Table 2. Sample Payment Amounts Under the Standard, Graduated, Extended-Fixed, and Extended-Graduated Plans for Direct and FFEL Consolidation Loans

Debt	Standard (10-30 years)			Graduated (10-30 years)				Extended-Fixed (25 yrs.)		Extended-Graduated (25 years)
	Maximum Repayment Period	Payment	Total Paid	Maximum Repayment Period	Minimum Payment	Maximum Payment	Total Paid	Payment	Total Paid	Minimum Payment	Maximum Payment	Total Paid
$20,000	20 years	$170	$40,899	20 years	$138	$241	$44,420	Not Eligible	-	Not Eligible	-	-
$30,000	20 years	$256	$61,349	20 years	$206	$362	$66,631	Not Eligible	-	Not Eligible	-	-
$40,000	25 years	$315	$94,614	25 years	$275	$417	$101,515	$315	$94,614	$275	$417	$101,515
$50,000	25 years	$394	$118,268	25 years	$344	$521	$126,899	$394	$118,268	$344	$521	$126,899
$60,000	30 years	$451	$162,274	30 years	$413	$549	$166,145	$473	$141,921	$413	$625	$152,280
$70,000	30 years	$526	$189,319	30 years	$481	$640	$193,841	$552	$165,575	$481	$730	$177,664
$80,000	30 years	$601	$216,365	30 years	$550	$732	$221,531	$631	$189,228	$550	$834	$203,046
$90,000	30 years	$676	$243,410	30 years	$619	$823	$249,228	$710	$212,882	$619	$938	$228,427

SECTION 11: SAMPLE PAYMENT AMOUNTS (CONTINUED)

Below are three tables that provide examples of monthly and total payment amounts under the IBR, Pay As You Earn, and ICR Plans. These figures are estimates, and use an interest rate of 8.25%. The figures also assume that you are single, do not have anyone else in your household, and that you live in one of the 48 contiguous states. Various factors, including your actual interest rate, the amount of your loan debt, your income, and whether and how quickly your income rises (these figures assume income increases 5% per year), may cause your payment amount to differ from the payment amounts shown in these tables. These figures use the 2013 Poverty Guidelines (published by the U.S. Department of Health and Human Services) and Income Percentage Factors.

Table 3. Sample Payment Amounts for the Income-Based Repayment (IBR) Plan for Those Who Are Not New Borrowers On/After July 1, 2014

Debt	Starting income of $25,000				Starting income of $40,000				Starting income of $60,000
	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)
$20,000	$97	$245	$43,861	219	Not Eligible	-	-	-	Not Eligible	-	-	-
$40,000	$97	$491	$89,628	300	$285	$491	$72,680	173	Not Eligible	-	-	-
$60,000	$97	$642	$94,175	300	$285	$736	$148,999	268	$535	$736	$97,093	143
$80,000	$97	$642	$94,175	300	$285	$981	$193,464	300	$535	$981	$156,150	193
$100,000	$97	$642	$94,175	300	$285	$1,227	$201,322	300	$535	$1,227	$236,102	251

Table 4. Sample Payment Amounts for the Pay As You Earn Plan for Eligible Borrowers & IBR Plan for Those Who Are New Borrowers On/After July 1, 2014

Debt	Starting income of $25,000				Starting income of $40,000				Starting income of $60,000
	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)
$20,000	$65	$245	$38,488	240	$190	$245	$31,254	134	Not Eligible	-	-	-
$40,000	$65	$309	$40,127	240	$190	$491	$85,707	240	$356	$491	$64,729	143
$60,000	$65	$309	$40,127	240	$190	$625	$89,727	240	$356	$736	$129,366	222
$80,000	$65	$309	$40,127	240	$190	$625	$89,727	240	$356	$981	$154,976	240
$100,000	$65	$309	$40,127	240	$190	$625	$89,727	240	$356	$1,046	$155,860	240

Table 5. Sample Payment Amounts for the Income-Contingent Repayment (ICR) Plan

Debt	Starting income of $25,000				Starting income of $40,000				Starting income of $60,000
	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)	Initial Payment	Final Payment	Total Paid	Time to Repay (Mos.)
$20,000	$151	$199	$43,436	249	$193	$219	$33,513	161	$219	$251	$30,761	131
$40,000	$225	$423	$96,630	274	$385	$438	$67,027	161	$438	$502	$61,523	131
$60,000	$225	$694	$146,629	300	$475	$658	$106,605	175	$658	$754	$92,284	131
$80,000	$225	$1,018	$162,256	300	$475	$939	$176,175	233	$809	$1,015	$124,521	240
$100,000	$225	$1,018	$163,256	300	$475	$1,360	$281,310	298	$809	$1,296	171,619	158

SECTION 12: 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 0.5 hours (30 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 682.215, 685.209, or 685.221. 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 1845-0102.

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(s) (see Section 7).

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