SCRA Interest Rate Limitation Request form

SERVICEMEMBERS CIVIL RELIEF ACT (SCRA): INTEREST
RATE LIMITATION REQUEST
SCRA

OMB No. 1845-0135
Form Approved
Exp. Date 10/31/2018

William D. Ford Federal Direct Loan (Direct Loan) Program and Federal Family
Education Loan (FFEL) Program
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: SERVICEMEMBER INFORMATION
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
Email (Optional)
SECTION 2: INFORMATION ABOUT THE SERVICEMEMBERS CIVIL RELIEF ACT
Under the Servicemembers Civil Relief Act (SCRA), the maximum interest rate that may be charged on an eligible Direct Loan
or FFEL Program loan is 6% during the period of the servicemember's qualifying military service.
Generally, you do not need to request that your loan holder limit the interest rate on your Direct Loans or FFEL Program loans
that are eligible for the SCRA interest rate limitation. Your loan holder will check the U.S. Department of Defense's Defense
Manpower Data Center (DMDC) on a regular basis and automatically apply the SCRA interest rate limitation if the information
in the DMDC shows that you qualify.
You can use this form if you have evidence of your military service that is more accurate than the information in the DMDC, or
if you are performing military service not reflected in the DMDC. There are other methods of requesting that your loan holder
apply the SCRA interest rate limitation to your Direct Loans and FFEL Program loans, including:
• Submitting a written request and a copy of your military orders; or
• Submitting an application for a military service deferment on your loan.
If you want to use this form to request application of the SCRA interest rate limit, carefully read the entire form, including
the instructions and definitions in Sections 5 and 6. Complete Section 3 and then have an authorized official complete
Section 4.
SECTION 3: SERVICEMEMBER REQUEST, UNDERSTANDING, AUTHORIZATION, AND CERTIFICATION
I request that for any of my eligible Direct Loans and FFEL Program loans, my loan holder limit the interest rate charged on
those loans to 6% during my qualifying military service.
I understand that my interest rate limitation will begin no earlier than August 14, 2008.
I authorize the entity to which I submit this request and its agents to contact me regarding my request or my loans at any
cellular telephone number that I provide now or in the future 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.
Date

Servicemember's Signature
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Name

SSN

SECTION 4: AUTHORIZED OFFICIAL'S CERTIFICATION
3. Is the servicemember activated from a reserve
component (Reserves or National Guard)?

1. Select the branch of military service that the
servicemember is a member of:
Army, Navy, Air Force, Marine Corps, or Coast
Guard (including Reserves and National Guard) Continue to Item 2.

Yes - Continue to Item 4.
No - Skip to Item 5.

Public Health Service - Continue to Item 2.

4. Provide the date the servicemember was notified of
his or her call to active duty and then continue to
Item 5.

National Oceanic and Atmospheric
Administration - Continue to Item 2.
None of the above - The servicemember is not
eligible for the SCRA interest rate limitation.
2. Select the level of service that the servicemember is
engaged in:

5. Provide the start date of the servicemember's active
duty military service or active service and then
continue to Item 6.

Active duty under 10 USC 101(d)(1) - Continue to
Item 3.
National Guard service under 32 USC 502(f)
authorized by the President or the Secretary of
Defense for a period of more than 30 consecutive
days to respond to a national emergency
declared by the President - Skip to Item 4.

6. Is the end date of the servicemember's military
service known?
Yes - Continue to Item 7.

Active service in the Public Health Service or in
the National Oceanic and Atmospheric
Administration - Skip to Item 5.

No - Complete the certification below.
7. Provide the end date of the servicemember's
military service and then complete the certification
below.

Absent from duty due to sickness, wounds, leave,
or other lawful cause - Skip to Item 5.
None of the above - The servicemember is not
eligible for the SCRA interest rate limitation.

I certify, to the best of my knowledge and belief, that the servicemember named above is performing military service as
indicated in this section.
Name of Military Branch or National Guard Component
Address
City

State

Zip Code

Telephone

Name and Title of Authorized Official

Date

Authorized Official's Signature

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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: March 14, 2015 =
03-14-2015. If you need help completing this form, contact your loan holder. If you want the SCRA interest rate limitation to
apply to loans that are held by different loan holders, you must submit a separate request to each loan holder. Return the
completed form to the address shown in Section 7.
SECTION 6: 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).
An authorized official who may complete Section 4 is your commanding officer, personnel officer, or unit-readiness
non-commissioned officer.
The holder of your Direct Loans is the U.S. Department of Education (the Department). The holder of your FFEL
Program loans may be a lender, secondary market, guaranty agency, or the Department. Your loan holder 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 or your servicer.
Period of qualifying military service means the period of time when:
• A member of the U.S. Army, Navy, Air Force, Marine Corps, or Coast Guard (or respective Reserve component) is on
active duty, including full-time duty in the active military service of the United States and full-time training duty,
annual training duty, and attendance, while in the active military service, at a school designated as a service school by
law or by the Secretary of the military department concerned, but not including full-time National Guard duty;
• A member of the National Guard is performing service on active duty or full-time National Guard duty authorized by
the President or the Secretary of Defense for a period of more than 30 consecutive days under 32 USC 502(f), for the
purposes of responding to a national emergency declared by the President and supported by Federal funds;
• A commissioned officer of the Public Health Service or the National Oceanic and Atmospheric Administration is on
active service; or
• A servicemember is absent from duty due to sickness, wounds, leave, or other lawful cause.
An eligible servicemember is a borrower with eligible Direct Loans or FFEL Program loans who received those
loans or an endorser who signed as such on an eligible Direct Loan or a FFEL Program loan prior to the date that the
period of qualifying military service began.
The interest rate includes interest and other charges or fees applied to the loan. During periods of qualifying active
duty military service, the interest rate on the eligible loan will not exceed 6%. If the interest rate is already below 6%, the
loan will retain the lower interest rate.
Eligible Direct Loans and FFEL Program loans are Direct Loan and FFEL Program loans made before the date the
period of qualifying military service began. A Direct or Federal Consolidation Loan is eligible only if you signed the
promissory note for the loan before the period of qualifying military service began
SECTION 7: WHERE TO SEND THE COMPLETED REQUEST
Return the completed form and any 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.)

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SECTION 8: 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., §451 et seq., or §461 of
the Higher Education Act of 1965, as amended (20 U.S.C.
1071 et seq., 20 U.S.C. 1087a et seq., or 20 U.S.C. 1087aa 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 William D. Ford Federal Direct
Loan (Direct Loan) Program, Federal Family Education Loan
(FFEL) Program, or Federal Perkins Loan (Perkins 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, FFEL, or Federal Perkins
Loan Programs, to permit the servicing of your loans, and, if
it becomes necessary, to locate you and to collect and
report on your loans if your loans become delinquent or
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 caseby-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 loans, to enforce the
terms of the loans, 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 such
collection displays a valid OMB control number. The valid
OMB control number for this information collection is
1845-0135. Public reporting burden for this collection of
information is estimated to average 20 minutes per
response, including time for reviewing instructions,
searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the
collection of information. If you have comments or concerns
regarding the status of your individual submission of this
form, please contact your loan holder directly (see Section
7).

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