REHABILITATION
TRAINING DEFERMENT REQUEST |
OMB No.
1845-0011 |
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.
You never need to pay for help with your federal student loans. Your loan servicer will help you for FREE. Contact your servicer if you have questions about this form or need any information regarding your federal student loans.
SECTION 1: BORROWER INFORMATION
Please enter or correct the following information.
Check this box if any of your information has changed.
Social Security Number (SSN) _________________________________________
Date of Birth (mm-dd-yyyy) _________________________________________
Name __________________________________________________________________
Address __________________________________________________________________
City _________________________________________
State ____________
Zip Code ____________
Phone – Primary ___________________________________
Phone - Alternate___________________________________
Email ___________________________________
SECTION 2: BORROWER DETERMINATION OF DEFERMENT ELIGIBILITY
Carefully read the entire form before completing it. Complete Section 2 in its entirety.
1. Is your program licensed, approved, certified, or recognized as providing rehabilitation training to disabled individuals by the Department of Veterans Affairs or a state agency responsible for vocational rehabilitation, drug abuse treatment, mental health treatment, or alcohol abuse services?
Yes - Continue to Item 2.
No - You are not eligible for this deferment.
2. Does your training program provide services under a written, individualized plan that specifies the date the services are expected to end?
Yes - Continue to Item 3.
No - You are not eligible for this deferment.
3. Does your program require a substantial commitment by you to your rehabilitation?
Substantial commitment means a commitment of time and effort that would normally prevent a person from being employed 30 or more hours per week in a position expected to last at least 3 months.
Yes - Continue to Item 4.
No - You are not eligible for this deferment.
4. Are you receiving or scheduled to receive vocational, drug abuse, mental health, or alcohol abuse rehabilitation services in your program?
Yes - Complete Section 3 and then have an authorized official complete Section 4.
No - You are not eligible for this deferment.
SECTION 3: BORROWER REQUESTS, UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
I request:
To defer repayment of my loans for the period during which I meet the eligibility criteria outlined in Section 2 and as certified by an authorized official in Section 4.
If checked, to make interest payments on my loans during my deferment.
I understand that:
I am not required to make payments of loan principal or interest during my deferment.
My deferment will begin on the date I became eligible, as certified by the authorized official.
My deferment will end on the earlier of the certified deferment end date or when I am no longer eligible for the deferment for another reason.
If I am a Perkins Loan borrower, I will receive a 6-month post-deferment grace period beginning on the date I no longer qualify for the deferment.
My loan holder may grant me a forbearance while processing my form or to cover any period of delinquency that exists when I submit my form.
All unpaid interest may capitalize on my loans during or at the expiration of my deferment or forbearance, but interest never capitalizes on Perkins Loans.
I certify, to the best of my knowledge and belief, that:
The information I have provided on this form is true and correct.
I will provide additional documentation to my loan holder, as required, to support my deferment eligibility.
I will notify my loan holder immediately when my eligibility for the deferment ends.
I have read, understand, and meet the eligibility requirements in Section 2.
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.
Borrower's Signature ___________________________________________________________
Date (mm-dd-yyyy)____________________________________________
SECTION 4: AUTHORIZED OFFICIAL'S CERTIFICATION
Borrower: Note: As an alternative to having an authorized official complete this section, you may attach separate documentation from an authorized official that includes all of the information requested below and a certification that you and the program meet all conditions indicated by your responses in Section 2.
Authorized Official: Do not complete this section unless the borrower has completed Section 2 in its entirety.
The program begins/began on: (mm-dd-yyyy)_______________________________
The program is expected to end/ended on: (mm-dd-yyyy)_______________________________
I certify, to the best of my knowledge and belief, that:
The borrower and the program meet all conditions indicated by the borrower’s responses in Section 2; and
The information that I have provided in this section is accurate.
Name of Institution _________________________________________________________________________
OPEID (if applicable) _______________________________
Address ____________________________________________________________________________
City ______________________________________________________
State ___________
Zip Code ___________
Official’s Name/Title ___________________________________________________________________
Phone __________________________________
Official’s Signature ___________________________________________________________
Date (mm-dd-yyyy)____________________________________________
SECTION 5: INSTRUCTIONS FOR COMPLETING THE DEFERMENT REQUEST
Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Example: March 14, 2024 = 03-14-2024. Include your name and account number on any documentation that you are required to submit with this form. 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. If you have loans that were made jointly to you and your spouse (as co-makers), both of you must individually meet the requirements for a deferment and each of you must submit a separate deferment request. Return the completed form and any required documentation to the address shown in Section 7.
SECTION 6: DEFINITIONS
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.
The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans, Federal PLUS Loans, Federal Consolidation Loans, and Federal Supplemental Loans for Students (SLS).
The Federal Perkins Loan (Perkins Loan) Program includes Federal Perkins Loans, National Direct Student Loans (NDSL), and National Defense Student Loans (Defense Loans).
An authorized official who may complete Section 4 is an official of the Rehabilitation Training Program.
Capitalization is the addition of unpaid interest to the principal balance of a Direct Loan Program or FFEL Program loan (interest never capitalizes on Perkins Loans). Capitalization causes more interest to accrue over the life of your loan and may cause your monthly payment amount to increase. The Capitalization Chart below provides an example of the monthly payments and the total amount repaid for a $30,000 unsubsidized loan. The example loan has a 6% interest rate and the example deferment lasts for 12 months and begins when the loan entered repayment. The example compares the effects of paying the interest as it accrues or allowing it to capitalize.
A co-maker is one of the two individuals who are joint borrowers on a Direct or Federal Consolidation Loan or a Federal PLUS Loan. Both co-makers are equally responsible for repaying the full amount of the loan.
A deferment is a period during which you are entitled to postpone repayment of your loans. Interest is not charged to you during a deferment on your subsidized loans. Interest is always charged to you during a deferment on your unsubsidized loans. Unpaid interest that accrues during a deferment on an unsubsidized Direct Loan or on an unsubsidized FFEL Program loan that is held by the Department is capitalized at the end of the deferment period. Unpaid interest that accrues during a deferment on a FFEL Program loan that is not held by the Department is capitalized at the end of the deferment but may be capitalized as frequently as quarterly on loans disbursed prior to 7/1/2000.
On loans made under the Perkins Loan Program, all deferments are followed by a post-deferment grace period of 6 months, during which time you are not required to make payments.
A forbearance is a period during which you are permitted to postpone making payments temporarily, allowed an extension of time for making payments, or temporarily allowed to make smaller payments than scheduled. Interest is charged during a forbearance on both subsidized and unsubsidized loans. Unpaid interest that accrues during a forbearance on a Direct Loan or on a FFEL Program loan that is held by the Department is not capitalized. Unpaid interest that accrues during a forbearance on a FFEL Program loan that is not held by the Department may be capitalized at the end of the forbearance but may be capitalized as frequently as quarterly on loans disbursed prior to 7/1/2000.
The holder of your Direct Loans is the Department. The holder of your FFEL Program loans may be a lender, guaranty agency, secondary market, or the Department. The holder of your Perkins Loans is an institution of higher education or the Department. Your loan holder may use a servicer to handle billing and other communications related to your loans. References to “your loan holder” on this form mean either your loan holder or your servicer.
A subsidized loan is a Direct Subsidized Loan, a Direct Subsidized Consolidation Loan, a Federal Subsidized Stafford Loan, portions of some Federal Consolidation Loans, a Federal Perkins Loan, an NDSL, and a Defense Loan.
An unsubsidized loan is a Direct Unsubsidized Loan, a Direct Unsubsidized Consolidation Loan, a Direct PLUS Loan, a Federal Unsubsidized Stafford Loan, a Federal PLUS Loan, a Federal SLS, and portions of some Federal Consolidation Loans.
Table 1. Capitalization Chart
Treatment of Interest with Deferment |
Loan Amount |
Capitalized Interest |
Outstanding Principal |
Monthly Payment |
Number of Payments |
Total Repaid |
Interest is paid |
$30,000 |
$0 |
$30,000 |
$333 |
120 |
$41,767 |
Interest is capitalized at the end |
$30,000 |
$1,800 |
$31,800 |
$353 |
120 |
$42,365 |
SECTION 7: WHERE TO SEND THE COMPLETED APPLICATION
Return the
completed form and any documentation to:
(If no address is
shown, return to your loan holder.)
|
SECTION 8: HELP WITH COMPLETING THE APPLICATION
If you need help
completing this form, call:
(If no phone number is shown, call
your loan holder.)
|
SECTION 9: IMPORTANT NOTICES
Privacy Act Statement
Authority: 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 William D. Ford Federal Direct Loan (Direct Loan) Program or Federal Family Education Loan (FFEL) Program and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate.
Purpose: The principal purposes for collecting the information on the Rehabilitation Training Deferment Request 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 loans, to enforce the conditions or terms of a title IV, HEA obligation, to originate, disburse, service, collect, assign, adjust, transfer, refer, furnish credit information for, and discharge a title IV, HEA obligation, to verify whether a title IV, HEA obligation qualifies for discharge, to determine credit balances to be refunded by the U.S. Department of the Treasury (Treasury) to the individual or loan holder, 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.
Disclosures: The information provided on the Rehabilitation Training Deferment Request form will only be disclosed outside of the U.S. Department of Education (Department) with prior written consent or as otherwise allowed by the Privacy Act of 1974, as amended (Privacy Act) (5 U.S.C. 552a). One of the exceptions to the Privacy Act’s prior written consent requirement that allows for disclosure, without consent, is for “routine uses” that the Department publishes in our System of Records Notices (SORNs). The Department may disclose, without consent, the information provided on a Rehabilitation Training Deferment Request form, on a case-by-case basis or under a computer matching program, to third parties pursuant to the routine uses identified in the “Common Services for Borrowers (CSB) System” (18-11-16) SORN. This notice is available on the Department’s “Privacy Act System of Record Notice Issuances (SORN)” webpage located at https://www2.ed.gov/notices/ed-pia.html.
These routine uses include, but are not limited to, the following:
To verify the identity of the individual who records indicate has applied for or received title IV, HEA program funds, disclosures may be made to guaranty agencies, educational and financial institutions, and their authorized representatives; to Federal, State, Tribal, or local agencies, and their authorized representatives; to private parties, such as relatives, business and personal associates, and present and former employers; to creditors; to consumer reporting agencies; to adjudicative bodies; and to the individual whom the records identify as the party obligated to repay the title IV, HEA obligation;
To determine program eligibility and benefits, disclosures may be made to guaranty agencies, educational and financial institutions, and their authorized representatives; to Federal, State, or local agencies, and their authorized representatives; to private parties, such as relatives, business and personal associates, and present and former employers; to creditors; to consumer reporting agencies; and to adjudicative bodies;
To provide customers with information to help them make informed decisions on repayment options, including deferment, forbearance, and recurring auto debit, based on their unique situations, disclosures may be made to guaranty agencies, educational and financial institutions, and their authorized representatives; and to Federal, State, or local agencies, and their authorized representatives.
For additional routine uses, view the “Common Services for Borrowers (CSB) System” (18-11-16) SORN. This notice is available on the Department’s “Privacy Act System of Record Notice Issuances (SORN)” webpage located at https://www2.ed.gov/notices/ed-pia.html.
Consequences of Failure to Provide Information: Participating in the Federal Family Education Loan (FFEL) Program or the William D. Ford Federal Direct Loan (Direct Loan) Program and providing the Department your SSN and requested information is mandatory to participate.
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 1845-0011. Public reporting burden for this collection of information is estimated to average 10 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. The obligation to respond to this collection is required to obtain a benefit in accordance with 34 CFR 674.34, 674.35, 674.36, 674.37, 682.210, or 685.204.
If you have comments or concerns regarding the status of your individual submission of this form, contact your loan holder directly.
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04/24/2024
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Jon Utz |
| File Modified | 0000-00-00 |
| File Created | 2024-09-24 |