Teacher Education Assistance for College and Higher Education Grant Program (TEACH Grant Program) Service Obligation Certification and Suspension Request Forms

TEACH GRANT SERVICE OBLIGATION SUSPENSION REQUEST:
MILITARY SPOUSE

OMB No. 1845-0158
Form Under Review
Exp. Date XX/XX/XXXX

Teacher Education Assistance for College and Higher Education (TEACH) Grant Program
MILSP

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.
GENERAL INFORMATION AND INSTRUCTIONS
NOTE: Throughout this form, the words “we,” “us,” and “our” refer to the U.S. Department of Education or to your TEACH Grant servicer, acting on
behalf of the U.S. Department of Education. The word “Agreement” refers to the Agreement to Serve or Repay that you signed before you received
your TEACH Grants.
How do I use this form?
As explained in your Agreement, you can request a suspension of the 8-year period for completing your TEACH Grant service obligation if you are
temporarily unable to teach due to certain qualifying conditions. You may use this form to request a suspension of the 8-year period for completing
your service obligation if you are temporarily unable to teach because your spouse has received military orders for a deployment with a military
unit or change of permanent duty station. See Section 5 of the form for specific eligibility requirements.
How do I complete the form?
•

Before you begin, carefully read the entire form. Print using dark ink.

•

Your name, address, and other information may be preprinted in Section 1. If any of this information is not shown, or if any of the preprinted
information is incorrect, enter or correct the information on the right side of Section 1. If any of your information has changed since the last
time you reported it to your TEACH Grant servicer, check the box in Section 1 to indicate this.

•

Complete Section 2:
o

Enter the beginning and ending dates (month and year only) of the school year for which you are requesting a suspension of the 8-year
service obligation period. For example, if you are requesting a suspension to cover a school year that begins in August 2024 and ends in
June 2025, you would enter “0 8 - 20 2 4” as the beginning date and “0 6 - 20 2 5” as the ending date.

o

Sign and date the form. Enter the date as month-day-year. For example, if you signed the form on August 25, 2025, you would enter
“0 8 - 2 5 - 20 2 5”.

•

Complete Section 3. Enter your spouse’s full name.

•

Have an authorized official complete Section 4, or attach documentation from the authorized official that includes all information requested in
Section 4. The authorized official may require you to provide additional documentation to confirm the identify of your spouse.

•

Make sure that all sections are complete, then send us the completed form by one of the following means:
o

Mail the form and any required documentation to the following address:
U.S. Department of Education
MOHELA
633 Spirit Drive
Chesterfield, MO 63005-1243

o
o

Fax the form to 1-866-222-7060.
Upload the form online atmohela.com/uploadDocument.

Who can I contact if I have questions?
The U.S. Department of Education uses a servicer to monitor your progress toward completing your TEACH Grant service obligation, and to answer
any questions you may have about your service obligation. It is very important to make sure that your TEACH Grant servicer has your current
contact information. If you need help completing this form, or if you have questions about the status of your request after you have submitted the
form, contact your TEACH Grant servicer:
MOHELA
1-888-866-4352
International: 636-532-0600
mohela.com

Page 1 of 4 – 30D DRAFT 09/12/2023

TEACH GRANT SERVICE OBLIGATION SUSPENSION REQUEST:
MILITARY SPOUSE
SECTION 1: GRANT RECIPIENT INFORMATION
See the instructions on page 1.
SSN ___ ___ ___ - ___ ___ - ___ ___ ___ ___
Name
___________________________________________________
Address ___________________________________________________
City, State, Zip _______________________________________________
Telephone – Primary
( _______ ) _______ - _________________
Telephone – Alternate
( _______ ) _______ - _________________
Email (optional)
___________________________________________
Check this box if you are changing any preprinted information.
SECTION 2: MILITARY SPOUSE SUSPENSION REQUEST, UNDERSTANDINGS, AND CERTIFICATIONS
I request that the U.S. Department of Education (ED) grant a temporary suspension of the period for completing my TEACH Grant service obligation
during the full elementary or secondary school year beginning ___ ___ - 20 ___ ___ and ending ___ ___ - 20 ___ ___. I am/was unable to complete
a full year of teaching service during this school year due to my spouse’s military deployment or change in duty station, as described in Section 5. I
have had an authorized official complete Section 4, or I have attached documentation from the official that includes all information requested in
Section 4.
I understand that (1) I may receive a suspension for a consecutive 12-month period; (2) if I continue to qualify for a suspension at the end of one
suspension period, I may reapply for another 12-month suspension, but I may not receive a total of more than 3 years of suspension based on my
spouse’s military deployment or change in duty station; (3) if I do not begin teaching or do not continue to perform qualifying teaching service
within a timeframe that would allow me to complete my required 4 years of teaching within the 8-year period required by my Agreement, my
TEACH Grants will be converted to Direct Unsubsidized Loans that I must repay; (4) my TEACH Grant servicer must receive my suspension request
before my TEACH Grants are converted to Direct Unsubsidized Loans; and (5) ED will not grant my suspension request unless this form is complete
and I have provided any required documentation.
I certify that: (1) the information I have provided on this form is true and correct; (2) I have read, understand, and meet the eligibility requirements
of the suspension that I have requested, as explained in Section 5; and (3) upon request, I will provide additional documentation to my TEACH
Grant servicer to support my suspension request.
Grant Recipient’s Signature __________________________________________________________________ Date ___ ___ - ___ ___ - 20 ___ ___
SECTION 3: SPOUSE’S INFORMATION
Spouse’s Full Name (printed) ________________________________________________________________________________________________
SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION
An authorized official who may complete this section is the commanding or personnel officer of the TEACH Grant recipient’s spouse.
BE SURE TO SIGN AND DATE THE FORM. Return the form to the TEACH Grant recipient identified in Section 1.
I certify that the TEACH Grant recipient’s spouse identified in Section 3 has received military orders for (check the appropriate box):
Deployment with a military unit or as an individual in support of a call or order to Federal or State Active Duty, or Active Service; or
A change of permanent duty station from a location in the continental United States to a location outside the continental United States, or from
a location in a state to any location outside of that state.
Authorized Official’s Name and Title (printed) __________________________________________________________________________________
Name of Military Organization ______________________________________________________________________________________________
Address (Street, City, State, Zip Code) ________________________________________________________________________________________
Telephone ( _______ ) _______ - _____________ Email __________________________________________________________________________
Authorized Official’s Signature ________________________________________________________________ Date ___ ___ - ___ ___ - 20 ___ ___

Page 2 of 4
U.S. Department of Education * MOHELA * 633 Spirit Drive * Chesterfield, MO 63005-1243 * Fax: 1-866-222-7060 * mohela.com
TEL: 1-888-866-4352 *International: 636-532-0600

SECTION 5: SUSPENSION ELIGIBILITY REQUIREMENTS AND MAXIMUM SUSPENSION PERIOD
Suspension eligibility requirements
You may qualify for a temporary suspension of the period for completing your TEACH Grant service obligation if you are temporarily unable to
teach because your spouse has received military orders for—
•
•

Deployment with a military unit or as an individual in support of a call to Federal or State Active Duty, or Active Service; or
A change of permanent duty station from a location in the continental United States to a location outside of the continental United
States or from a location in a state to any location outside of that state.

If you qualify for a suspension, your TEACH Grant servicer must receive your suspension request before your TEACH Grants are converted to Direct
Unsubsidized Loans. Refer to your Agreement or contact us (see “Who can I contact if I have questions?” on page 1) for more information about
the terms and conditions under which your TEACH Grants may be converted to loans.
Maximum suspension period
If you meet the requirements described in this section, you will receive a temporary suspension of the 8-year period for completing your TEACH
Grant service obligation for a consecutive 12-month period covering the school year during which you are temporarily unable to teach. If you
continue to qualify for a suspension at the end of one suspension period, you may reapply for another 12-month suspension. However, there is a
maximum 3-year limit on the period of time for which you may receive a suspension of the 8-year service obligation period based on your spouse’s
military deployment or change of permanent duty station.
SECTION 6: IMPORTANT NOTICES
PRIVACY ACT NOTICE

Justice, a court, adjudicative body, counsel, party, or witness if the
The Privacy Act of 1974 (5 U.S.C. 552a) requires that the following notice disclosure is relevant and necessary to the litigation. If this information,
either alone or with other information, indicates a potential violation of
be provided to you:
The authorities for collecting the requested information from and about law, we may send it to the appropriate authority for action. We may
you are §420L et seq. and §451 et seq. of the Higher Education Act (HEA) send information to members of Congress if you ask them to help you
with federal student aid questions. In circumstances involving
of 1965, as amended (20 U.S.C. 1070g et seq. and 20 U.S.C. 1087a et
employment complaints, grievances, or disciplinary actions, we may
seq.) and the authorities for collecting and using your social security
disclose
relevant records to adjudicate or investigate the issues. If
number (SSN) are §484(a)(4) of the HEA (20 U.S.C. 1091(a)(4)) and
provided
for by a collective bargaining agreement, we may disclose
§31001(i)(1) of the Debt Collection Improvement Act of 1996 (31 U.S.C.
records
to
a labor organization recognized under 5 U.S.C. Chapter 71.
7701(c)). Participating in the Teacher Education Assistance for College
Disclosures
may be made to our contractors for the purpose of
and Higher Education (TEACH) Grant Program and/or the William D.
performing
any
programmatic function that requires disclosure of
Ford Federal Direct Loan (Direct Loan) Program and giving us your SSN
records.
Before
making any such disclosure, we will require the
are voluntary, but you must provide the requested information,
contractor to maintain Privacy Act safeguards. Disclosures may also be
including your SSN, to participate.
made to qualified researchers under Privacy Act safeguards.
The principal purposes for collecting the information on this form,
If your TEACH Grant has been converted to a Direct Unsubsidized Loan,
including your SSN, are to verify your identity, to determine your
the routine uses of this information also include, but are not limited to,
eligibility to receive a TEACH Grant, and, if a TEACH Grant that you
its disclosure to federal, state, or local agencies, to private parties such
receive is converted to a Direct Unsubsidized Loan, to determine
as relatives, present and former employers, business and personal
your eligibility to receive a benefit on the loan (such as deferment,
associates, to creditors, to financial and educational institutions, and to
forbearance, discharge, or forgiveness), to permit the servicing of
guaranty agencies to verify your identity, to determine your program
your loan(s), and, if it becomes necessary, to locate you and to
eligibility and benefits, to permit making, servicing, assigning, collecting,
collect and report on your loan(s) if your loan(s) become delinquent
adjusting or discharging your loan(s), to enforce the terms of the loan(s),
or in default. We also use your SSN as an account identifier and to
to investigate possible fraud and to verify compliance with federal
permit you to access your account information electronically.
student financial aid program regulations, to locate you if you become
The information in your file may be disclosed, on a case-by-case basis or
delinquent in your loan payments or if you default, or to verify whether
under a computer matching program, to third parties as authorized
your debt qualifies for discharge or cancellation. To provide default rate
under routine uses in the appropriate systems of records notices.
calculations, disclosures may be made to guaranty agencies, to financial
The routine uses of the information that we collect about you, if your
and educational institutions, or to federal, state or local agencies. To
TEACH Grant has not been converted to a Direct Unsubsidized Loan,
provide financial aid history information, disclosures may be made to
include, but are not limited to, its disclosure to federal, state, or local
educational institutions. To assist program administrators with tracking
agencies, to institutions of higher education, and to third party servicers refunds and cancellations, disclosures may be made to guaranty
to determine your eligibility to receive a TEACH Grant, to investigate
agencies, to financial and educational institutions, or to federal or state
possible fraud, and to verify compliance with federal student financial
agencies.
aid program regulations.
In the event of litigation, we may send records to the Department of
Page 3 of 4
U.S. Department of Education * MOHELA * 633 Spirit Drive * Chesterfield, MO 63005-1243 * Fax: 1-866-222-7060 * mohela.com
TEL: 1-888-866-4352 *International: 636-532-0600

SECTION 6: IMPORTANT NOTICES (CONTINUED)
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.
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. The valid OMB control number for
this information collection is 1845-0158. Public reporting burden for this
collection of information is estimated to average 20 minutes (0.33
hours) per response, including time for reviewing instructions, searching
existing data resources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. The obligation
to respond to this collection is required to obtain a benefit in
accordance with 34 CFR 686.41(b).
If you have comments or concerns regarding the status of your
individual submission of this form, write to:
U.S. Department of Education
MOHELA
633 Spirit Drive
Chesterfield, MO 63005-1243

Page 4 of 4
U.S. Department of Education * MOHELA * 633 Spirit Drive * Chesterfield, MO 63005-1243 * Fax: 1-866-222-7060 * mohela.com
TEL: 1-888-866-4352 *International: 636-532-0600