Federal Loan Economic Hardship Request – Fill Out and Use This PDF

ECONOMIC HARDSHIP DEFERMENT REQUEST

OMB No. 1845-0011

William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family

Form Approved

Exp. Date 8/31/2021

Education Loan (FFEL) Program / Federal Perkins Loan (Perkins Loan) Program

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on

HRD

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 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

1. Have you received this type of deferment on a loan

5.

What is your monthly income?

made under another federal student loan program for

You must attach documentation of your monthly

the same period of time that you want this deferment?

income. Monthly income is either (you choose):

For example, check "yes" if you want this

• Your gross taxable income from all sources or

deferment on your Direct Loans and you are on this

• One-twelfth of the Adjusted Gross Income from

deferment on your FFEL Program loans.

Yes - Attach documentation of the deferment.

your most recent federal income tax return.

Skip to Section 3.

6.

What is your family size ?

No - Continue to Item 2.

2. Have you received or are you receiving payments

Family size includes:

•

You;

under a federal or state public assistance program for

the same period of time that you want this deferment?

•

Your spouse;

Qualifying programs include: Temporary

• Your children if they receive more than half of

Assistance for Needy Families (TANF), Supplemental

their support from you, including unborn children

Security Income (SSI), Supplemental Nutrition

who will be born during the deferment period;

Assistance Program (SNAP), state general public

and

assistance, or other means-tested benefits.

• Other people if, at the time you request this

Yes - Attach documentation of the payments.

Skip to Section 3.

deferment, they live with you, receive more than

No - Continue to Item 3.

half their support from you, and will continue to

3. Are you serving as a Peace Corps volunteer?

receive this support from you during the

deferment period. Support includes money, gifts,

Yes - Attach documentation certifying your

loans, housing, food, clothes, car, medical and

period of service. Skip to Section 3.

dental care, and payment of college costs.

No - Continue to Item 4.

7. Is the amount you reported in Item 5 less than 150%

4. Do you work full time?

of the poverty guideline for your family size and state

of residence (see Table 2 in Section 5)?

Full-time employment means working 30 or more

hours per week in a position expected to last at least 3

Yes - Continue to Section 3.

consecutive months.

No - You are not eligible for this deferment.

Yes - Continue to Item 5.

No - You are not eligible for this deferment.

Borrower Name

Borrower SSN

•

If checked, to make interest

payments on my

loans during my deferment.

Borrower's Signature

Date

The William D. Ford Federal Direct Loan (Direct

The Federal Family Education Loan (FFEL) Program

Loan) Program includes Federal Direct Stafford/Ford

includes Federal Stafford Loans, Federal PLUS Loans, Federal

(Direct Subsidized) Loans, Federal Direct Unsubsidized

Consolidation Loans, and Federal Supplemental Loans for

Stafford/Ford (Direct Unsubsidized) Loans, Federal

Students (SLS).

Direct PLUS (Direct PLUS) Loans, and Federal Direct

The Federal Perkins Loan (Perkins Loan) Program

Consolidation (Direct Consolidation) Loans.

includes Federal Perkins Loans, National Direct Student Loans

(NDSL), and National Defense Student Loans (Defense Loans).

Capitalization is the addition of unpaid interest to

A forbearance is a period during which you are permitted

the principal balance of your loan. Capitalization causes

to postpone making payments temporarily, allowed an

more interest to accrue over the life of your loan and

extension of time for making payments, or temporarily

may cause your monthly payment amount to increase.

allowed to make smaller payments than scheduled.

Interest never capitalizes on Perkins Loans.

The holder of your Direct Loans is the Department. The

Table 1 (below) provides an example of the monthly

holder of your FFEL Program loans may be a lender, guaranty

payments and the total amount repaid for a $30,000

agency, secondary market, or the Department. The holder of

unsubsidized loan. The example loan has a 6% interest

your Perkins Loans is an institution of higher education or the

rate and the example deferment or forbearance lasts for

Department. Your loan holder may use a servicer to handle

12 months and begins when the loan entered

billing and other communications related to your loans.

repayment. The example compares the effects of paying

References to “your loan holder” on this form mean either

the interest as it accrues or allowing it to capitalize.

your loan holder or your servicer.

A co-maker is one of the two individuals who are

A subsidized loan is a Direct Subsidized Loan, a Direct

joint borrowers on a Direct or Federal Consolidation

Subsidized Consolidation Loan, a Federal Subsidized Stafford

Loan or a Federal PLUS Loan. Both co-makers are

Loan, portions of some Federal Consolidation Loans, a Federal

responsible for repayment the full amount of the loan.

Perkins Loan, an NDSL, and a Defense Loan.

A deferment is a period during which you are

An unsubsidized loan is a Direct Unsubsidized Loan, a

entitled to postpone repayment of your loans. Interest is

Direct Unsubsidized Consolidation Loan, a Direct PLUS Loan, a

not generally charged to you during a deferment on

Federal Unsubsidized Stafford Loan, a Federal PLUS Loan, a

your subsidized loans. Interest is always charged to you

Federal SLS, and portions of some Federal Consolidation

during a deferment on your unsubsidized loans. On

Loans.

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.

Table 1. Capitalization Chart

Treatment of Interest with

Loan

Capitalized

Outstanding

Monthly

Number of

Total

Deferment/Forbearance

Amount

Interest

Principal

Payment

Payments

Repaid

Interest is paid

$30,000

$0

$30,000

$333

120

$41,767

Interest is capitalized at the

$30,000

$1,800

$31,800

$353

120

$42,365

end

Interest is capitalized

$30,000

$1,841

$31,841

$354

120

$42,420

quarterly and at the end

Table 2. 150% of the Poverty Guidelines for 2019 (Monthly)

Family Size

Alaska

Hawaii

All Others

1

$1,950.00

$1,797.50

$1,561.25

2

$2,641.25

$2,432.50

$2,113.75

3

$3,332.50

$3,067.50

$2,666.25

4

$4,023.75

$3,702.50

$3,218.75

5

$4,715.00

$4,337.50

$3,771.25

6

$5,406.25

$4,972.50

$4,323.75

7

$6,097.50

$5,607.50

$4,876.25

8

$6,788.75

$6,242.50

$5,428.75

Each additional

$691.25

$635.00

$552.50

person, add

If you do not live in the United States, use the poverty guideline amount in

the column labeled "All Others".

Privacy Act Notice. The Privacy Act of 1974 (5 U.S.C. 552a)

To assist program administrators with tracking refunds

requires that the following notice be provided to you:

and cancellations, disclosures may be made to guaranty

The authorities for collecting the requested information

agencies, to financial and educational institutions, or to

federal or state agencies. To provide a standardized method

from and about you are §421 et seq., §451 et seq., or §461 et

for educational institutions to efficiently submit student

seq. of the Higher Education Act of 1965, as amended (20

enrollment statuses, disclosures may be made to guaranty

U.S.C. 1071 et seq., 20 U.S.C. 1087a et seq., or 20 U.S.C. 1087aa

agencies or to financial and educational institutions. To

et seq.) and the authorities for collecting and using your Social

counsel you in repayment efforts, disclosures may be made

Security Number (SSN) are §§428B(f) and 484(a)(4) of the HEA

to guaranty agencies, to financial and educational

(20 U.S.C. 1078-2(f) and 1091(a)(4)) and 31 U.S.C. 7701(b).

institutions, or to federal, state, or local agencies.

Participating in the William D. Ford Federal Direct Loan (Direct

Loan) Program, Federal Family Education Loan (FFEL)

In the event of litigation, we may send records to the

Program, or Federal Perkins Loan (Perkins Loan) Program and

Department of Justice, a court, adjudicative body, counsel,

giving us your SSN are voluntary, but you must provide the

party, or witness if the disclosure is relevant and necessary

requested information, including your SSN, to participate.

to the litigation. If this information, either alone or with

The principal purposes for collecting the information on

other information, indicates a potential violation of law, we

may send it to the appropriate authority for action. We may

this form, including your SSN, are to verify your identity, to

send information to members of Congress if you ask them

determine your eligibility to receive a loan or a benefit on a

to help you with federal student aid questions. In

loan (such as a deferment, forbearance, discharge, or

circumstances involving employment complaints,

forgiveness) under the Direct Loan, FFEL, or Federal Perkins

grievances, or disciplinary actions, we may disclose relevant

Loan Programs, to permit the servicing of your loans, and, if it

records to adjudicate or investigate the issues. If provided

becomes necessary, to locate you and to collect and report on

for by a collective bargaining agreement, we may disclose

your loans if your loans become delinquent or default. We also

records to a labor organization recognized under 5 U.S.C.

use your SSN as an account identifier and to permit you to

Chapter 71. Disclosures may be made to our contractors for

access your account information electronically.

the purpose of performing any programmatic function that

The information in your file may be disclosed, on a case-

requires disclosure of records. Before making any such

by-case basis or under a computer matching program, to third

disclosure, we will require the contractor to maintain Privacy

parties as authorized under routine uses in the appropriate

Act safeguards. Disclosures may also be made to qualified

systems of records notices. The routine uses of this

researchers under Privacy Act safeguards.

information include, but are not limited to, its disclosure to

Paperwork Reduction Notice. According to the

federal, state, or local agencies, to private parties such as

Paperwork Reduction Act of 1995, no persons are required

relatives, present and former employers, business and

to respond to a collection of information unless such

personal associates, to consumer reporting agencies, to

collection displays a valid OMB control number. The valid

financial and educational institutions, and to guaranty

OMB control number for this information collection is

agencies in order to verify your identity, to determine your

1845-0011. Public reporting burden for this collection of

eligibility to receive a loan or a benefit on a loan, to permit the

information is estimated to average 10 minutes per

servicing or collection of your loans, to enforce the terms of

response, including time for reviewing instructions,

the loans, to investigate possible fraud and to verify

searching existing data sources, gathering and maintaining

compliance with federal student financial aid program

the data needed, and completing and reviewing the

regulations, or to locate you if you become delinquent in your

collection of information. The obligation to respond to this

loan payments or if you default. To provide default rate

collection is required to obtain a benefit in accordance with

calculations, disclosures may be made to guaranty agencies,

34 CFR 674.34, 674.35, 674.36, 674.37, 682.210, or 685.204.

to financial and educational institutions, or to state agencies.

If you have comments or concerns regarding the

To provide financial aid history information, disclosures may

status of your individual submission of this form, please

be made to educational institutions.

contact your loan holder directly (see Section 6).