Mandatory Forbearance Request Form PDF Details

Are you having trouble making payments on your student loan debt? Have you been affected by the COVID-19 pandemic and are looking for ways to relieve your financial stress? A forbearance request form might be just what you need. Federal loans allow borrowers to temporarily pause payments or reduce their payment amounts if they’re experiencing a legitimate hardship due to an illness, military service, unemployment, or other factors. This blog post will go over how to submit a mandatory forbearance request form and offer tips for successfully requesting one. Keep reading for more information about this essential resource!

QuestionAnswer
Form NameMandatory Forbearance Request Form
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesWashington, false, SSN, OMB

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Page 1 of 5

MANDATORY FORBEARANCE REQUEST

OMB No. 1845-0018

Medical or Dental Internship/Residency, National Guard Duty, or Department

Form Approved

Exp. Date 8/31/2021

of Defense Student Loan Repayment Program Forbearance

 

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

 

Education Loan (FFEL) Program

 

SERV

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.

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

Telephone - Alternate

Email (Optional)

SECTION 2: BORROWER DETERMINATION OF FORBEARANCE ELIGIBILITY

Carefully read the entire form before completing it. Complete the applicable part of Section 2 in its entirety. This form covers three different types of forbearance. Review the information for each forbearance type to determine whether you qualify for that forbearance.

PART A. MEDICAL OR DENTAL INTERNSHIP/RESIDENCY

You only qualify for this forbearance if you do not qualify for a medical or dental internship/residency deferment.

1.Have you been accepted into an internship/residency?

Yes - Continue to Item 2.

No - You are not eligible for this forbearance.

2.Did your program require for admission that you have a bachelor's degree?

Yes - Continue to Item 3.

No - You are not eligible for this forbearance.

3.Will you receive supervised training in your internship/residency program?

Yes - Continue to Item 4.

No - You are not eligible for this forbearance.

4.Will completion of your program lead to a degree or certificate awarded by an institution of higher education, a hospital, or a health care facility that offers postgraduate training?

Yes - Complete Section 3 and have an authorized official complete Section 4.

No - Continue to Item 5.

5.Is completion of all or a portion of the program required before you can begin professional practice or service?

Yes - Complete Section 3 and have an authorized official complete Section 4. In addition, you must attach a separate statement from the appropriate state licensing agency certifying this requirement. No - You are not eligible for this forbearance.

PART B. NATIONAL GUARD DUTY

You only qualify for this forbearance if you do not qualify for a military service deferment.

6.Are you a member of the National Guard?

Yes - Continue to Item 7.

No - You are not eligible for this forbearance.

7.Are you engaged in active state duty for a period of more than 30 consecutive days because a governor activated you based on state statute or policy?

Yes - Continue to Item 8.

No - Skip to Item 9.

8.Is your service being paid for with state funds?

Yes - Skip to Item 11.

No - Continue to Item 9.

Borrower Name

 

Borrower SSN

 

 

 

SECTION 2: BORROWER DETERMINATION OF FORBEARANCE ELIGIBILITY (CONTINUED)

9.Are you engaged in active state duty for a period of more than 30 consecutive days under which a governor activated you with the approval of the President or the U.S. Secretary of Defense?

Yes - Continue to Item 10.

No - You are not eligible for this forbearance.

10.Is your service being paid for with federal funds?

Yes - Continue to Item 11.

No - You are not eligible for this forbearance.

11.Were you activated no more than 6 months after the last date on which you were enrolled in school at least half-time?

Yes - Complete Section 3 and have an authorized official (a commanding or personnel officer) complete Section 4.

No - You are not eligible for this forbearance.

PART C. DEPARTMENT OF DEFENSE STUDENT LOAN REPAYMENT PROGRAM

12.Are you performing service that qualifies you for a partial repayment of your loans under any Department of Defense Student Loan Repayment Program?

Yes - Complete Section 3 and have an authorized official from the Department of Defense complete Section 4.

No - You are not eligible for this forbearance.

SECTION 3: BORROWER REQUESTS, UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION

Irequest:

My loan holder grant forbearance for the period during which I meet the qualifications for the forbearance. If

 

approved for a forbearance, I would like to:

 

 

 

 

 

Temporarily stop making payments; or

 

 

 

 

 

Make smaller payments in the amount of

 

per month.

 

 

 

 

 

 

 

 

 

 

 

 

My loan holder grant my forbearance for up to 12 months unless I specify an earlier end date:

.

 

 

 

 

If checked, to make interest payments on my loans during forbearance.

 

 

Iunderstand:

I am not required to make payments of loan principal or interest during forbearance.

My forbearance will begin on the date the program or service that qualifies me for forbearance began, as certified by the authorized official.

My loan holder may grant me an additional forbearance while processing my form or to cover any period of delinquency that exists when I submit my form.

My forbearance will end on the earlier of the date I am no longer eligible for the forbearance, 12 months from the start date of the forbearance, or the end date I requested.

My forbearance will only be granted in increments of up to 12 months, and I must reapply for the forbearance if I continue to meet the eligibility requirements and want to extend my forbearance.

Interest may capitalize on my loans during or at the expiration of my forbearance.

Page 2 of 5

Borrower NameBorrower SSN

SECTION 3: BORROWER REQUESTS, UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION (CONTINUED)

I certify 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 forbearance eligibility.

I will notify my loan holder immediately when my eligibility for the forbearance 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 prerecorded voice or text messages.

Borrower's Signature

 

Date

 

 

 

 

 

SECTION 4: AUTHORIZED OFFICIAL'S CERTIFICATION

Do not complete this section unless the borrower has completed the applicable part of Section 2 in its entirety. Note: Instead of 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. For the National Guard Duty forbearance, you may attach a copy of your orders.

The program/service begins/began on:

The program/service is expected to end/ended on:

I certify, to the best of my knowledge and belief, that:

The borrower named above is/was engaged in the program/service indicated in Section 2;

The borrower and program/service 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/Organization

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

City

 

State

 

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

Official's Name/Title

 

 

 

Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Official's Signature

 

 

 

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM

Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Example: March 14, 2019 = 03-14-2019. Include your name and account number on any documentation that you submit with this form. If you want to apply for a forbearance on loans that are held by different loan holders, you must submit a separate forbearance request to each loan holder. Return

the completed form and any required documentation to the address shown in Section 7.

Endorsers may request forbearance only when you are required to repay the loan because the borrower is not making payments. For those who have loans made jointly (as co-makers), both borrowers must individually meet the requirements for a forbearance and each of you must submit a separate forbearance request.

Page 3 of 5

SECTION 6: DEFINITIONS

The William D. Ford Federal Direct Loan (Direct

An endorser is an individual who sings a promissory

Loan) Program includes Federal Direct Stafford/Ford

note and agrees to pay the loan if teh borrower sdoes not.

(Direct Subsidized) Loans, Federal Direct Unsubsidized

A deferment is a period during which you are entitled

Stafford/Ford (Direct Unsubsidized) Loans, Federal Direct

to postpone repayment of your loans. Interest is not

PLUS (Direct PLUS) Loans, and Federal Direct

 

 

generally charged to you during a deferment on your

Consolidation (Direct Consolidation) Loans.

 

 

subsidized loans. Interest is always charged to you during

 

The Federal Family Education Loan (FFEL) Program

 

a deferment on your unsubsidized loans.

 

 

includes Federal Stafford Loans, Federal PLUS Loans,

 

 

A forbearance is a period during which you are

Federal Consolidation Loans, and Federal Supplemental

allowed to postpone making payments temporarily,

Loans for Students (SLS).

 

 

 

 

 

 

allowed an extension of time for making payments, or

An authorized official for the medical or dental

temporarily allowed to make smaller payments than

internship/residency forbearance is an official from your

scheduled. A forbearance can be a mandatory

internship/residency program. An authorized official for

forbearance, meaning that your loan holder must grant

the National Guard State Duty forbearance is your

 

 

the forbearance if you qualify for the forbearance and

commanding or personnel officer. An authorized official

supply all supporting documentation. A forbearance can

for the Department of Defense Student Loan Repayment

also be a discretionary forbearance, meaning that your

Program forbearance is an official from the Department of

loan holder may grant the forbearance, but is not required

Defense.

 

 

 

 

 

 

to do so.

 

 

 

 

 

 

 

 

 

 

 

 

 

Capitalization is the addition of unpaid interest to the

The holder of your Direct Loan Program loans is the

principal balance of your loan. Capitalization causes more

Department. The holder of your FFEL Program loans may

interest to accrue over the life of the loan and may cause

be a lender, guaranty agency, secondary market, or the

your monthly payment amount to increase. Table 1

Department. Your loan holder may use a servicer to

(below) provides an example of the monthly payments

handle billing and other communications related to your

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

loans. References to “your loan holder” on this form mean

loan. The example loan has a 6% interest rate and the

either your loan holder or your servicer.

 

 

example deferment or forbearance lasts for 12 months

 

 

A subsidized loan is a Direct Subsidized Loan, a Direct

and begins when the loan entered repayment. The

Subsidized Consolidation Loan, a Federal Subsidized

example compares the effects of paying the interest as it

Stafford Loan, and portions of some Federal Consolidation

accrues or allowing it to capitalize.

 

 

Loans.

 

 

 

 

A co-maker is one of the two individual who are joint

 

 

 

 

An unsubsidized loan is a Direct Unsubsidized Loan, a

borrowers on a Direct or Federal Consolidation Loan or a

Direct Unsubsidized Consolidation Loan, a Direct PLUS

Federal PLUS Loan. Both co-makers are equally

 

 

Loan, a Federal Unsubsidized Stafford Loan, a Federal

responsible for repaying the full amount of the loan.

PLUS Loan, a Federal SLS, and portions of some Federal

 

 

 

 

 

Table 1. Capitalization Chart

 

 

 

Consolidation Loans.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Treatment of Interest with

Loan Amount

 

Capitalized

Outstanding

Monthly

Number of

Total Repaid

 

 

Deferment/Forbearance

 

Interest

Principal

Payment

Payments

 

 

 

 

 

 

 

 

 

 

 

 

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION 7: WHERE TO SEND THE COMPLETED FORBEARANCE REQUEST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Return the completed form and any documentation to: (If no address is shown, return to your loan holder.)

If you need help completing this form, call:

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

Page 4 of 5

SECTION 8: IMPORTANT NOTICES

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

To assist program administrators with tracking

552a) requires that the following notice be provided to you:

refunds and cancellations, disclosures may be made to

The authorities for collecting the requested

guaranty agencies, to financial and educational institutions,

or to federal or state agencies. To provide a standardized

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

method for educational institutions to efficiently submit

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

student enrollment statuses, disclosures may be made to

U.S.C. 1071 et seq. or 20 U.S.C. 1087a et seq.) and the

guaranty agencies or to financial and educational

authorities for collecting and using your Social Security

institutions. To counsel you in repayment efforts, disclosures

Number (SSN) are §§428B(f) and 484(a)(4) of the HEA (20

may be made to guaranty agencies, to financial and

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

educational institutions, or to federal, state, or local

Participating in the William D. Ford Federal Direct Loan

agencies.

(Direct Loan) Program or Federal Family Education Loan

 

(FFEL) Program and giving us your SSN are voluntary, but

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

you must provide the requested information, including your

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

SSN, to participate.

party, or witness if the disclosure is relevant and necessary

The principal purposes for collecting the

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

other information, indicates a potential violation of law, we

information on this form, including your SSN, are to verify

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

your identity, to determine your eligibility to receive a loan

send information to members of Congress if you ask them

or a benefit on a loan (such as a deferment, forbearance,

to help you with federal student aid questions. In

discharge, or forgiveness) under the Direct Loan or FFEL

circumstances involving employment complaints,

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

grievances, or disciplinary actions, we may disclose relevant

becomes necessary, to locate you and to collect and report

records to adjudicate or investigate the issues. If provided

on your loans if your loans become delinquent or default.

for by a collective bargaining agreement, we may disclose

We also use your SSN as an account identifier and to permit

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

you to access your account information electronically.

Chapter 71. Disclosures may be made to our contractors for

The information in your file may be disclosed, on a

the purpose of performing any programmatic function that

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

requires disclosure of records. Before making any such

to third parties as authorized under routine uses in the

disclosure, we will require the contractor to maintain Privacy

appropriate systems of records notices. The routine uses of

Act safeguards. Disclosures may also be made to qualified

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

researchers under Privacy Act safeguards.

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

Paperwork Reduction Notice. According to the

relatives, present and former employers, business and

Paperwork Reduction Act of 1995, no persons are required

personal associates, to consumer reporting agencies, to

to respond to a collection of information unless such

financial and educational institutions, and to guaranty

collection displays a valid OMB control number. The valid

agencies in order to verify your identity, to determine your

OMB control number for this information collection is

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

1845-0018. Public reporting burden for this collection of

the servicing or collection of your loans, to enforce the

information is estimated to average 15 minutes per

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

response, including time for reviewing instructions,

compliance with federal student financial aid program

searching existing data sources, gathering and maintaining

regulations, or to locate you if you become delinquent in

the data needed, and completing and reviewing the

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

collection of information. The obligation to respond to this

calculations, disclosures may be made to guaranty agencies,

collection is required to obtain a benefit in accordance with

to financial and educational institutions, or to state

34 CFR 682.211 or 685.205.

agencies. To provide financial aid history information,

If you have comments or concerns regarding the

disclosures may be made to educational institutions.

status of your individual submission of this form, please

 

 

contact your loan holder directly (see Section 7).

Page 5 of 5

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2. Once your current task is complete, take the next step – fill out all of these fields - a bachelors degree, Yes Continue to Item No You are, Will you receive supervised, internshipresidency program, You only qualify for this, Are you a member of the National, Yes Continue to Item No You are, Yes Continue to Item No You are, Are you engaged in active state, Will completion of your program, certificate awarded by an, Yes Complete Section and have an, Yes Continue to Item No Skip to, Is your service being paid for, and Yes Skip to Item No Continue to with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

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