Da Form 5261 4 R – Fill Out and Use This PDF

STUDENT LOAN REPAYMENT PROGRAM ADDENDUM

For use of this form, see AR 135-7; the proponent agency is ODCSPER.

ARNGUS: ADDENDUM TO DD FORM 4 SERIES (ENLISTMENT/REENLISTMENT DOCUMENT - ARMED FORCES OF THE UNITED STATES) OR DA FORM 4836 (OATH OF EXTENSION OF ENLISTMENT OR REENLISTMENT)

USAR: ADDENDUM TO DA FORM 3540 SERIES (CERTIFICATE AND ACKNOWLEDGMENT OF SERVICE REQUIREMENTS FOR INDIVIDUALS ENLISTING, REENLISTING, OR TRANSFERRING INTO TROOP PROGRAM UNITS OF THE U.S. ARMY RESERVE)

NOTE; THE TERM "EXTENSION," AS USED IN THIS ADDENDUM, APPLIES TO ARMY NATIONAL GUARD OF THE UNITED STATES (ARNGUS) SOLDIERS WHO MAY INITIALLY CONTRACT FOR THIS PROGRAM EITHER BY REENLISTMENT OR EXTENSION. U.S. ARMY RESERVE (USAR) SOLDIERS INITIALLY CONTRACT FOR THIS PROGRAM ONLY BY REENLISTMENT. SUBSEQUENT EXTENSIONS OF THE INITIAL ARNGUS OF USAR CONTRACTED TERM OF SERVICE WILL EXTEND THE SOLDIER'S ENTITLEMENTS UNDER THIS PROGRAM

DATA REQUIRED BY THE PRIVACY ACT OF 1974

SECTION l - APPLICABILITY

This addendum will be completed by all persons enlisting, reenlisting, immediately reenlisting, or extending in the Selected Reserve of the Army (ARNGUS or USAR) for entitlement under the Student Loan Repayment Program (SLRP).

SECTION ll - INSTRUCTIONS

The service representative is responsible for reading and explaining the SLRP requirements outlined on this form. Following the reading, explanation, and affixing of proper signatures, a copy of this form will be stapled to each copy of the DD Form 4 series, or DA Form 4836, for ARNGUS personnel, or the DA Form 3540 series for USAR personnel.

SECTION lll - ACKNOWLEDGMENT

In connection with my enlistment, immediate reenlistment, or extension in the Army National Guard of the United States (ARNGUS) or U.S. Army Reserve (USAR), for entitlement to loan repayment under the Student Loan Repayment Program, I hereby acknowledge that I meet the following eligibility criteria (The applicant will initial the applicable paragraphs):

1.________________ I have no previous military service, or I have previous military service but I have not completed initial entry training and I am contracting for an initial Selected Reserve term of service of at least 6 years with a concurrent contractual and statutory military service obligation of 8 years. In addition-

a.I have scored 50 or higher on the Armed Forces Qualifications Test (AFQT).

b.I am contracting for completion of initial active duty for training (IADT) and qualification in military occupational specialty

(MOS)	which HQDA has approved for:
_______________ (1)	A maximum of $10,000 in loan repayments; or
_______________ (2)	A maximum of $20,000 in loan repayments (USAR only).

c. I am a secondary school graduate and I have the supporting documentation: or I am currently in high school and --

_______________ (1) I have enlisted for the Standard Training Option. I must present proof of high school graduation

before I enter on IADT; or

_______________ (2) I have enlisted for the Alternate (Split) Training Option. I must submit proof of high school

graduation before I enter on the second phase of IADT. This addendum is void if I enter the second phase of training without proof of graduation.

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SECTION III - ACKNOWLEDGMENT (Continued)

_________________ 2. I have previous military service, or I am currently a member of the ARNGUS or USAR, and I am contracting to serve

for 3 more years in the Selected Reserve. In addition, I am contracting:
a. To serve in military occupational specialty (MOS)				(in which I am qualified) and that HQDA has approved for:
(Initial as appropriate.)
_________________	(1)	A maximum of $10,000 in loan repayments; or
_________________	(2)	A maximum of $20,000 in loan repayments (USAR only).
_________________	b.	For assignment to a Selected Reserve training brigade/division in a valid drill sergeant duty position for which I am,

or will become within 24 months, SQI "X" qualified.

3.I am not contracting in the ARNGUS/USAR to fill a permanent civilian position where membership in the Selected Reserve is a condition of employment (temporary civilian assignment is excluded).

4.I am a high school graduate or equivalent and I have the supporting documentation as required by AR 135-7 and AR 601-210.

SECTION IV - OBLIGATION

I will serve satisfactorily, as prescribed by National Guard or Department of the Army regulations, the obligated term of service in the Selected Reserve according to my enlistment, reenlistment, or extension agreement unless expressly excused for the convenience of the Government. I incur the obligations of this contractual agreement as follows: (Initial the paragraph below that is applicable to you.)

________________ 1. I have no previous military service. I am enlisting for 8 years (8x0 or 6x2) in the ARNGUS/USAR. I agree to serve my

initial 6 years in the Selected Reserve in the MOS I have indicated in section III, paragraph 1b above.

________________ 2. I am not a current member of the ARNGUS/USAR, but I have previous military service. I am enlisting or reenlisting for

years (must be 3 or more years) in the ARNGUS/USAR. I agree to serve the entire term of service in the Selected Reserve in

the MOS I have indicated in section III, paragraph 2.
________________ 3. I am currently a member of the ARNGUS/USAR. I am immediately reenlisting or extending for			years
(must be 3 or more years). I agree to serve the entire term of service in the Selected Reserve in the MOS I have indicated in section III,
paragraph 2.

SECTION V - ENTITLEMENT

I understand that loan repayment under the SLRP will apply to me as follows:

1.The Government will repay a designated portion of any outstanding loan(s) I have secured since 1 October 1975. Such loan(s) must have been made, insured, or guaranteed under Part B of the Higher Education Act of 1965 (Guaranteed Student Loans/Federally Insured Student Loans), or any loan made under Part E of such act (National Direct Student Loans).

2.In addition, qualifying educational loan(s) made by me while a member of the Selected Reserve during this contractual term of service will also be repaid in part under this incentive.

3.Repayment of the qualifying student loan(s) will be made after each year of satisfactory service in the Selected Reserve after securing the loan(s) and reaching the anniversary date of this agreement. For each year of satisfactory service in the Selected Reserve, the loan amount to be repaid will be as follows: (The applicant will initial the applicable paragraph.)

________________ a. A maximum of $10,000 during my military career as I have acknowledged in section III, above, and that amount will not
increase. The amount to be repaid each year will not exceed 15% of the original balance (a maximum of $1,500) or $500, whichever is greater,
plus the accrued interest.
________________ b. A maximum of $20,000 during my military career as I have acknowledged in section III, above, and that amount
will not increase. The amount to be repaid each year will not exceed 15% of the original balance (a maximum of $3,000)		or $500, whichever is
the greater, plus the accrued interest. Further, I understand my eligibility for the $20,000 SLRP is based on MOS			as shown
in section III, above. I will be subject to reduced benefits if I move to an MOS not eligible for this amount.

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SECTION V - ENTITLEMENT (Continued)

_________________ 4. I understand that--

a.The repayment of student loans by the Government is not automatic under the terms of this addendum. It is my responsibility to initiate the request for loan repayments during each year that I meet the requirements explained in this addendum, by completing DD Form 2475

(DOD Educational Loan Repayment Program (LRP) Annual Application) and submitting it to personnel officials in my command.

b.I should arrange for deferment or forbearance with lenders or note holders on loans which are falling due.

c.Loan repayments will only be made to the lender or noteholder and nothing in this agreement will be construed as authority to refund any repayment of a loan.

5.Loan repayments are subject to Federal and State income tax withholdings.

SECTION VI - SUSPENSION

I understand that under certain conditions I can be suspended on a one-time basis for a specified period from loan repayment under the SLRP rather than being terminated. Suspensions are limited to the following conditions:

1.Temporary overseas residence, missionary obligation, or overseas employment obligation for 3 years or less. Also transfer to the Inactive National Guard or Individual Ready Reserve for personal reasons up to 1 year. Reinstatement to a partial or full resumption of loan repayments, when authorized, requires extending my term of service equal to the period I was in a nonavailable status and reestablishing my eligibility and adjusting my anniversary date.

2.I must continue to serve in the MOS for which I contracted. If I am reassigned to another duty MOS in which I am not qualified, loan repayment will be suspended. I must become MOS qualified within 12 months if on-the-job training (OJT) is required, or within 24 months if attendance at a service school is required. However, except where my MOS duty position has been changed through unit reorganization, relocation, redesignation, inactivation, or conversion --

a.If I contracted for the $20,000 loan repayment (section V, para 3b) I must become qualified in an MOS which HQDA has approved for this amount or I will be subject to reduced benefits (section V, para 3a); and

b.If otherwise eligible, I will be entitled to loan repayment when I become MOS qualified in the new position.

3.If I enter a period of service where favorable personnel actions on my behalf are suspended, entitlement to subsequent payments will also be suspended. If otherwise eligible, I will be entitled to loan repayments (section V, para 3) when the suspension has been lifted. This excludes suspension of favorable personnel actions for Army Physical Fitness Test failure or failure to meet body fat standards.

SECTION VII - TERMINATION

(Applicant must initial this block) I understand that the terms of this addendum will remain in force as long as I continue to participate satisfactorily under a contractual agreement as a member of the Selected Reserve. I further understand that the terms of this agreement and my entitlement to loan repayment under the SLRP will be terminated should any of the following conditions occur:

1.Become an unsatisfactory participant per AR 135-91.

2.If I move to an MOS, or am reclassified in an MOS, other than that for which contracted. Loan repayment will not be terminated if I remain assigned to the Selected Reserve (see para 11 below) and I am moved to another MOS for normal career progression, or when my unit is reorganized, relocated, redesignated, inactivated, or converted, or where the Chief, National Guard Bureau or Chief, Army Reserved has approved the move.

3.Fail to become MOS qualified within 12 months, if required to perform on-the-job training, or within 24 months if required to attend a service school, following a voluntary reassignment to a position in an MOS other than that for which I have herein contracted.

4.Am separated from my enlisted status in the Selected Reserve, for any reason, except for an authorized period of nonavailability. This includes enlistment in the Regular Army or voluntary entry on extended active duty in the Active Army.

5. Accept a permanent civilian position where membership in the Selected Reserve is a condition of employment (a temporary civilian

assignment is excluded).

6. Exceed the maximum period authorized for suspension during a period of nonavailability.

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SECTION VII - TERMINATION (Continued)

7.Fail to extend my ARNGUS or USAR contracted term of service to compensate for a period of nonavailability.

8.Enter on active duty in an Active Guard Reserve (AGR) status, provided this would be my initial entry on active duty and I am enrolled under the Montgomery GI Bill for active duty service (38 USC Chapter 30).

9.Enroll in Senior Reserve Officers Training Corps (SROTC) with assignment to Control Group (ROTC), or if I become a participant in the ROTC Simultaneous Membership Program (SMP).

10.Was attending high school at the time of enlistment and I do not become a secondary school graduate within the required timeframe.

11. Have reached the maximum portion authorized for loan repayment during my service as a Reserve of the Army (ARNGUS and USAR service combined). The maximum portion of loan repayment that I am authorized during my career is shown in section III, paragraph 2b, above.

_________________ 12. (Applicant must initial) Transfer between the USAR and the ARNGUS under the following conditions:

a.If, as a member of the USAR entitled to loan repayment at the $10,000 or $20,000 level, I transfer to the ARNGUS --

(1)Because my USAR troop program unit has been reorganized, relocated, redesignated, inactivated, or converted, I will terminate my entitlement at the $20,000 level, but will not terminate my entitlement to loan repayment. I will continue entitlement to loan repayment but only at the $10,000 level.

(2)For any reason other the (1) above, I will terminate my entitlement to loan repayment at both the $10,000 and $20,000 levels, unless the Chief, National Guard Bureau authorizes continued entitlement at the time of enlistment in the ARNGUS.

b.If, as a member of the ARNGUS entitled to loan repayment under this program, I transfer to a USAR Selected Reserve unit and I remain otherwise eligible, I will not terminate my entitlement and will continue entitlement for loan repayment. However, this transfer will not authorize increasing my entitlement to the $20,000 level.

13.Was attending high school at the time of enlistment and I do not become a secondary school graduate within the required timeframe.

SECTION VIII - STATEMENT OF UNDERSTANDING

I have read and understand each of the statements above and have had my questions satisfactorily answered. I understand the statements above are intended to constitute all promises and agreements, whatsoever, concerning my entitlement, reenlistment, or extension under the SLRP. Any other promise, representation, or commitments, made to me in connection with my enlistment, reenlistment, or extension for the SLRP have been entered below in my own handwriting, or they are hereby waived. (If none, indicate by writing the word "NONE" below.)

SECTION IX - CERTIFICATION BY SERVICE REPRESENTATIVE

I certify that I have witnessed the reading and signing of the above agreement and the signature appearing above is that of the applicant. I have verified the soldier meets the eligibility requirements of AR 135-7, and the applicant's MOS is currently eligible for the designated portion authorized for loan repayment shown in section III, above. No other promises were made to the applicant as a condition of entitlement under the SLRP. I have provided the applicant with a copy of this form.

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