Fedloan Servicing Deferment Form – Fill Out and Use This PDF

Return the completed form and any documentation to:

If you need help completing this form, call:

(If no address is shown, return to your loan holder.)

(If no phone number is shown, call your loan holder.)

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

To assist program administrators with tracking refunds

552a) 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

for educational institutions to efficiently submit student

et. 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.

agencies or to financial and educational institutions. To

1087aa et seq.) and the authorities for collecting and using

counsel you in repayment efforts, disclosures may be made

your Social Security Number (SSN) are §§428B(f) and 484(a)

to guaranty agencies, to financial and educational

(4) of the HEA (20 U.S.C. 1078-2(f) and 1091(a)(4)) and 31

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

U.S.C. 7701(b). Participating in the William D. Ford Federal

Direct Loan (Direct Loan) Program, Federal Family Education

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

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

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

Program and giving us your SSN are voluntary, but you must

party, or witness if the disclosure is relevant and necessary

provide the requested information, including your SSN, to

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

participate.

other information, indicates a potential violation of law, we

The principal purposes for collecting the information on

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

send information to members of Congress if you ask them

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

to help you with federal student aid questions. In

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

circumstances involving employment complaints,

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

grievances, or disciplinary actions, we may disclose relevant

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

records to adjudicate or investigate the issues. If provided

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

for by a collective bargaining agreement, we may disclose

it becomes necessary, to locate you and to collect and

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

report on your loans if your loans become delinquent or

Chapter 71. Disclosures may be made to our contractors for

default. We also use your SSN as an account identifier and to

the purpose of performing any programmatic function that

permit you to access your account information

requires disclosure of records. Before making any such

electronically.

disclosure, we will require the contractor to maintain Privacy

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

Act safeguards. Disclosures may also be made to qualified

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

researchers under Privacy Act safeguards.

third parties as authorized under routine uses in the

Paperwork Reduction Notice. According to the

appropriate systems of records notices. The routine uses of

Paperwork Reduction Act of 1995, no persons are required

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

to respond to a collection of information unless such

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

collection displays a valid OMB control number. The valid

relatives, present and former employers, business and

OMB control number for this information collection is

personal associates, to consumer reporting agencies, to

1845-0011. Public reporting burden for this collection of

financial and educational institutions, and to guaranty

information is estimated to average 10 minutes per

agencies in order to verify your identity, to determine your

response, including time for reviewing instructions,

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

searching existing data sources, gathering and maintaining

the servicing or collection of your loans, to enforce the

the data needed, and completing and reviewing the

terms of the loans, to investigate possible fraud and to verify

collection of information. The obligation to respond to this

compliance with federal student financial aid program

collection is required to obtain a benefit in accordance with

regulations, or to locate you if you become delinquent in

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

your loan payments or if you default. To provide default rate

If you have comments or concerns regarding the

calculations, disclosures may be made to guaranty agencies,

status of your individual submission of this form, please

to financial and educational institutions, or to state

contact your loan holder directly (see Section 7).

agencies. To provide financial aid history information,

disclosures may be made to educational institutions.

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