<table>
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<tbody>
<tr class="odd">
<td><p id="section" class="heading"><img src="media/image1.png"
style="width:0.87986in;height:0.69792in" /></p></td>
<td colspan="17"><h2 id="in-school-deferment-request">IN-SCHOOL
DEFERMENT REQUEST</h2>
<h3 id="federal-family-education-loan-program">Federal Family Education
Loan Program </h3>
<h3
id="warning-any-person-who-knowingly-makes-a-false-statement-or-misrepresentation-on-this-form-or-on-any-accompanying-documents-is-subject-to-penalties-that-may-include-fines-imprisonment-or-both-under-the-u.s.-criminal-code-and-20-u.s.c.-1097.">WARNING:
Any person who knowingly makes a false statement or misrepresentation on
this form or on any accompanying documents is subject to penalties that
may include fines, imprisonment, or both, under the U.S. Criminal Code
and 20 U.S.C. 1097.</h3></td>
<td></td>
</tr>
<tr class="even">
<td colspan="19"><h2 id="section-1-borrower-identification"><em>SECTION
1: BORROWER IDENTIFICATION</em></h2></td>
</tr>
<tr class="odd">
<td colspan="6"><h2 id="section-1"></h2></td>
<td colspan="13"><p>Please enter or correct the following
information.</p>
<p>SSN |__|__|__|-|__|__|-|__|__|__|__|</p></td>
</tr>
<tr class="even">
<td colspan="6"><h2 id="section-2"></h2></td>
<td>Name</td>
<td colspan="12"></td>
</tr>
<tr class="odd">
<td colspan="6"><h2 id="section-3"></h2></td>
<td colspan="3">Address</td>
<td colspan="10"></td>
</tr>
<tr class="even">
<td colspan="6"><h2 id="section-4"></h2></td>
<td colspan="5">City, State, Zip Code</td>
<td colspan="8"></td>
</tr>
<tr class="odd">
<td colspan="6"><h2 id="section-5"></h2></td>
<td colspan="6">Telephone - Home ( )</td>
<td colspan="7"></td>
</tr>
<tr class="even">
<td colspan="6"><h2 id="section-6"></h2></td>
<td colspan="6">Telephone - Other ( )</td>
<td colspan="7"></td>
</tr>
<tr class="odd">
<td colspan="6"><h2 id="section-7"></h2></td>
<td colspan="8">E-mail Address (Optional)</td>
<td colspan="5"></td>
</tr>
<tr class="even">
<td colspan="6"><h2 id="section-8"></h2></td>
<td colspan="13"></td>
</tr>
<tr class="odd">
<td colspan="19"><h2 id="section-2-deferment-request"><em>SECTION 2:
DEFERMENT REQUEST</em></h2></td>
</tr>
<tr class="even">
<td colspan="19"><h2
id="before-answering-any-questions-carefully-read-the-entire-form-including-the-instructions-and-other-information-in-sections-5-and-6."><em>Before
answering any questions, carefully read the entire form, including the
instructions and other information in Sections 5 and 6.</em></h2>
<p> I meet the qualifications for the deferment(s) checked below and
request that my loan holder defer repayment of my loan(s) (check all
that apply):</p>
<blockquote>
<p> While I am enrolled <strong>FULL TIME</strong> at an eligible
school<strong>.</strong> (For borrowers with any FFEL Program loan.)</p>
<p> While I am enrolled <strong>AT LEAST HALF TIME</strong> at an
eligible school. (For borrowers who, on the date they signed the
promissory note, did not have an outstanding balance on a FFEL Program
loan made <strong>before July 1, 1987</strong>; Federal PLUS Loans first
disbursed <strong>on or after July 1, 2008</strong>, are eligible
regardless of when the oldest outstanding loan was made.)</p>
<p> If I am a parent borrower of a Federal PLUS Loan first disbursed
<strong>on or after July 1, 2008</strong>, during the 6-month period
after I cease to be enrolled at least half time at an eligible
school.</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="19"><h2
id="section-3-borrower-understandings-certifications-and-authorization"><em>SECTION
3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND
AUTHORIZATION</em></h2></td>
</tr>
<tr class="even">
<td colspan="19"><p> <strong>I understand that:</strong></p>
<blockquote>
<p><strong>(1)</strong> I am not required to make payments of loan
principal during my deferment. Interest will not be charged on my
subsidized loan(s) during my deferment. However, interest will be
charged on my unsubsidized loan(s).</p>
<p><strong>(2)</strong> I have the option of paying the interest that
accrues on my unsubsidized loan(s) during my deferment.</p>
<p><strong>(3)</strong> I may choose to make interest payments by
checking the box below. My loan holder may capitalize interest that I do
not pay during the deferment period.</p>
<p> I wish to make interest payments on my unsubsidized loan(s) during
my deferment.</p>
</blockquote>
<h2
id="my-deferment-will-begin-on-the-date-i-began-full-time-or-at-least-half-time-enrollment-as-certified-by-the-authorized-official-who-completes-section-4-of-this-form-and-will-end-on-the-earlier-of-the-date-that-i-cease-to-meet-the-enrollment-status-requirement-that-qualifies-me-for-the-deferment-or-the-expected-ending-date-of-my-qualifying-enrollment-status-as-certified-by-the-authorized-official.">(4)
My deferment will begin on the date I began full-time or at least
half-time enrollment, as certified by the authorized official who
completes Section 4 of this form, and will end on the earlier of the
date that I cease to meet the enrollment status requirement that
qualifies me for the deferment, or the expected ending date of my
qualifying enrollment status as certified by the authorized official.
</h2>
<h2
id="if-i-am-a-graduate-or-professional-student-federal-plus-loan-borrower-i-will-also-receive-a-deferment-on-my-federal-plus-loans-first-disbursed-on-or-after-july-1-2008-during-the-6-month-period-after-i-cease-to-be-enrolled-on-at-least-a-half-time-basis.">(5)
If I am a graduate or professional student Federal PLUS Loan borrower, I
will also receive a deferment on my Federal PLUS Loan(s) first disbursed
on or after July 1, 2008 during the 6-month period after I cease to be
enrolled on at least a half-time basis. </h2>
<h2
id="if-i-am-a-parent-borrower-of-a-federal-plus-loan-first-disbursed-on-or-after-july-1-2008-and-i-request-a-deferment-during-the-6-month-period-after-i-cease-to-be-enrolled-on-at-least-a-half-time-basis-my-deferment-will-begin-on-the-day-after-i-cease-to-be-enrolled-at-least-half-time-and-will-end-six-months-after-that-date.">(6)
If I am a parent borrower of a Federal PLUS Loan first disbursed on or
after July 1, 2008 and I request a deferment during the 6-month period
after I cease to be enrolled on at least a half-time basis, my deferment
will begin on the day after I cease to be enrolled at least half time
and will end six months after that date.</h2>
<h2
id="if-my-deferment-does-not-cover-all-my-past-due-payments-my-loan-holder-may-grant-me-a-forbearance-for-all-payments-due-before-the-begin-date-of-my-deferment-orif-the-period-for-which-i-am-eligible-for-a-deferment-has-endeda-forbearance-for-all-payments-due-at-the-time-my-deferment-request-is-processed.">(7)
If my deferment does not cover all my past due payments, my loan holder
may grant me a forbearance for all payments due before the begin date of
my deferment or—if the period for which I am eligible for a deferment
has ended—a forbearance for all payments due at the time my deferment
request is processed. </h2>
<h2
id="my-loan-holder-may-grant-me-a-forbearance-on-my-loans-for-up-to-60-days-if-necessary-for-the-collection-and-processing-of-documentation-related-to-my-deferment-request.-interest-that-accrues-during-the-forbearance-will-not-be-capitalized.">(8)
My loan holder may grant me a forbearance on my loans for up to 60 days,
if necessary, for the collection and processing of documentation related
to my deferment request. Interest that accrues during the forbearance
will not be capitalized.</h2>
<blockquote>
<p> <strong>I certify that: (1)</strong> The information I provided in
Sections 1 and 2 above is true and correct. <strong>(2)</strong> I will
provide additional documentation to my loan holder, as required, to
support my deferment status. <strong>(3)</strong> I will notify my loan
holder immediately when the enrollment status that qualified me for the
deferment ends. <strong>(4)</strong> I have read, understand, and meet
the eligibility criteria of the deferment for which I have applied.</p>
<p><strong></strong> <strong>I authorize</strong> the school, the
lender, the guarantor, the Department, and their respective agents and
contractors to contact me regarding my loan(s), including repayment of
my loan(s), at the current or any future number that I provide for my
cellular telephone or other wireless device using automated telephone
dialing equipment or artificial or prerecorded voice or text
messages.</p>
</blockquote></td>
</tr>
<tr class="odd">
<td colspan="3"><h2 id="borrowers-signature">Borrower’s
Signature</h2></td>
<td colspan="10"><h2 id="section-9"></h2></td>
<td colspan="4"><h2 id="date">Date</h2></td>
<td colspan="2"><h2 id="section-10"></h2></td>
</tr>
<tr class="even">
<td colspan="19"><h2 id="section-11"></h2></td>
</tr>
<tr class="odd">
<td colspan="19"><h2
id="section-4-authorized-officials-certification"><em>SECTION 4:
AUTHORIZED OFFICIAL’S CERTIFICATION</em></h2></td>
</tr>
<tr class="even">
<td colspan="19"><p><strong>NOTE: <em>As an alternative to completing
this section, the school may attach its own enrollment certification
report listing the required information.</em></strong></p>
<p><strong>I certify</strong>, to the best of my knowledge and belief,
that the borrower named above:</p>
<p><strong>(1)</strong> is/was enrolled as (check the appropriate box) a
full-time student or at least a half-time student</p>
<blockquote>
<p>during the academic period from |__|__|-|__|__|-|__|__|__|__| to
|__|__|-|__|__|-|__|__|__|__| and</p>
</blockquote>
<h2
id="is-reasonably-expected-to-complete-hisher-program-requirements-on-____-____-________.">(2)
is reasonably expected to complete his/her program requirements on
|__|__|-|__|__|-|__|__|__|__|.</h2></td>
</tr>
<tr class="odd">
<td colspan="2">Name of Institution</td>
<td colspan="6"></td>
<td colspan="2"></td>
<td colspan="5">OPE-ID</td>
<td colspan="4"></td>
</tr>
<tr class="even">
<td colspan="2">Address</td>
<td colspan="6"></td>
<td colspan="2"></td>
<td colspan="6">City, State, Zip Code</td>
<td colspan="3"></td>
</tr>
<tr class="odd">
<td colspan="5">Name/Title of Authorized Official</td>
<td colspan="3"></td>
<td colspan="2"></td>
<td colspan="7">Telephone ( )</td>
<td colspan="2"></td>
</tr>
<tr class="even">
<td colspan="4"><strong>Authorized Official’s Signature</strong></td>
<td colspan="4"></td>
<td colspan="2"></td>
<td colspan="5"><strong>Date</strong></td>
<td colspan="4"></td>
</tr>
</tbody>
</table>

+-----------------------------------+-----------------------------------+
| ######### SECTION 5: INS          |                                   |
| TRUCTIONS FOR COMPLETING THE FORM |                                   |
+-----------------------------------+-----------------------------------+
| Type or print using dark ink.     |                                   |
| Report dates as month-day-year    |                                   |
| (MM-DD-YYYY). For example,        |                                   |
| 'January 31, 2009' =              |                                   |
| '01-31-2009'. An authorized       |                                   |
| school official must either       |                                   |
| complete Section 4 or attach the  |                                   |
| school's own enrollment           |                                   |
| certification report listing the  |                                   |
| required information. If you need |                                   |
| help completing this form,        |                                   |
| contact your loan holder.         |                                   |
|                                   |                                   |
| ***Return the completed form and  |                                   |
| any required documentation to the |                                   |
| address shown in Section 7.***    |                                   |
+-----------------------------------+-----------------------------------+
| ***SECTION 6: DEFINITIONS***      |                                   |
+-----------------------------------+-----------------------------------+
| **** An **authorized certifying  |                                   |
| official** for an In-School       |                                   |
| Deferment is an authorized        |                                   |
| official of the school where I    |                                   |
| am/was enrolled as a full-time or |                                   |
| at least half-time student.       |                                   |
|                                   |                                   |
| **** **Capitalization** is the   |                                   |
| addition of unpaid interest to    |                                   |
| the principal balance of my loan. |                                   |
| This will increase the principal  |                                   |
| and the total cost of my loan.    |                                   |
|                                   |                                   |
| **** A **deferment** is a period |                                   |
| during which I am entitled to     |                                   |
| postpone repayment of the         |                                   |
| principal balance of my loan(s).  |                                   |
| The federal government pays the   |                                   |
| interest that accrues during an   |                                   |
| eligible deferment for all        |                                   |
| subsidized Federal Stafford Loans |                                   |
| and for Federal Consolidation     |                                   |
| Loans for which the Consolidation |                                   |
| Loan application was received by  |                                   |
| my loan holder **(1)** on or      |                                   |
| after January 1, 1993, but before |                                   |
| August 10, 1993, **(2)** on or    |                                   |
| after August 10, 1993, if it      |                                   |
| includes ***only*** Federal       |                                   |
| Stafford Loans that were eligible |                                   |
| for federal interest subsidy, or  |                                   |
| **(3)** on or after November 13,  |                                   |
| 1997, for that portion of the     |                                   |
| Consolidation Loan that paid a    |                                   |
| subsidized FFEL Loan or a         |                                   |
| subsidized Federal Direct Loan. I |                                   |
| am responsible for the interest   |                                   |
| that accrues during this period   |                                   |
| on all other FFEL Program loans.  |                                   |
|                                   |                                   |
| **** The **Federal Family        |                                   |
| Education Loan (FFEL) Program**   |                                   |
| includes Federal Stafford Loans   |                                   |
| (both subsidized and              |                                   |
| unsubsidized), Federal            |                                   |
| Supplemental Loans for Students   |                                   |
| (SLS), Federal PLUS Loans, and    |                                   |
| Federal Consolidation Loans.      |                                   |
|                                   |                                   |
| ** Forbearance** means           |                                   |
| permitting the temporary          |                                   |
| cessation of payments, allowing   |                                   |
| an extension of time for making   |                                   |
| payments, or temporarily          |                                   |
| accepting smaller payments than   |                                   |
| previously scheduled. I am        |                                   |
| responsible for the interest that |                                   |
| accrues on my loan(s) during a    |                                   |
| forbearance. If I do not pay the  |                                   |
| interest that accrues, the        |                                   |
| interest may be capitalized.      |                                   |
|                                   |                                   |
| **** The **holder** of my FFEL   |                                   |
| Program loan(s) may be a lender,  |                                   |
| guaranty agency, secondary        |                                   |
| market, or the U.S. Department of |                                   |
| Education.                        |                                   |
+-----------------------------------+-----------------------------------+
| ***SECTION 7: WHERE TO SEND THE   |                                   |
| COMPLETED DEFERMENT REQUEST***    |                                   |
+-----------------------------------+-----------------------------------+
| Return the completed deferment    | If you need help completing this  |
| request and any required          | form, call:                       |
| documentation to:                 |                                   |
|                                   | (If no telephone number is shown, |
| (If no address is shown, return   | call your loan holder.)           |
| to your loan holder.)             |                                   |
+-----------------------------------+-----------------------------------+
| ***SECTION 8: IMPORTANT           |                                   |
| NOTICES***                        |                                   |
+-----------------------------------+-----------------------------------+
| ####### Privacy Act Notice        |                                   |
|                                   |                                   |
| The Privacy Act of 1974 (5 U.S.C. |                                   |
| 552a) requires that the following |                                   |
| notice be provided to you:        |                                   |
|                                   |                                   |
| The authority for collecting the  |                                   |
| requested information from and    |                                   |
| about you is §421 et seq. of the  |                                   |
| Higher Education Act (HEA) of     |                                   |
| 1965, as amended (20 U.S.C. 1071  |                                   |
| et seq.) and the authorities for  |                                   |
| collecting and using your Social  |                                   |
| Security Number (SSN) are         |                                   |
| §484(a)(4) of the HEA (20 U.S.C.  |                                   |
| 1091(a)(4)) and 31 U.S.C.         |                                   |
| 7701(b). Participating in the     |                                   |
| Federal Family Education Loan     |                                   |
| Program (FFELP) and giving us     |                                   |
| your SSN are voluntary, but you   |                                   |
| must provide the requested        |                                   |
| information, including your SSN,  |                                   |
| to participate.                   |                                   |
|                                   |                                   |
| The principal purposes for        |                                   |
| collecting the information on     |                                   |
| this 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 FFELP, to  |                                   |
| permit the servicing of your      |                                   |
| loan(s), and, if it becomes       |                                   |
| necessary, to locate you and to   |                                   |
| collect and report on your        |                                   |
| loan(s) if your loan(s) becomes   |                                   |
| delinquent or in default. We also |                                   |
| use your SSN as an account        |                                   |
| identifier and to permit you to   |                                   |
| access your account information   |                                   |
| electronically.                   |                                   |
|                                   |                                   |
| The information in your file may  |                                   |
| be disclosed, on a case-by-case   |                                   |
| basis or under a computer         |                                   |
| matching program, to third        |                                   |
| parties as authorized under       |                                   |
| routine uses in the appropriate   |                                   |
| systems of records notices. The   |                                   |
| routine uses of this information  |                                   |
| include, but are not limited to,  |                                   |
| its disclosure to federal, state, |                                   |
| or local agencies, to private     |                                   |
| parties such as relatives,        |                                   |
| present and former employers,     |                                   |
| business and personal associates, |                                   |
| to consumer reporting agencies,   |                                   |
| to financial and educational      |                                   |
| institutions, and to guaranty     |                                   |
| agencies in order to verify your  |                                   |
| identity, to determine your       |                                   |
| eligibility to receive a loan or  |                                   |
| a benefit on a loan, to permit    |                                   |
| the servicing or collection of    |                                   |
| your loan(s), to enforce the      |                                   |
| terms of the loan(s), to          |                                   |
| investigate possible fraud and to |                                   |
| verify compliance with federal    |                                   |
| student financial aid program     |                                   |
| regulations, or to locate you if  |                                   |
| you become delinquent in your     |                                   |
| loan payments or if you default.  |                                   |
| To provide default rate           |                                   |
| calculations, disclosures may be  |                                   |
| made to guaranty agencies, to     |                                   |
| financial and educational         |                                   |
| institutions, or to state         |                                   |
| agencies. To provide financial    |                                   |
| aid history information,          |                                   |
| disclosures may be made to        |                                   |
| educational institutions. To      |                                   |
| assist program administrators     |                                   |
| with tracking refunds and         |                                   |
| cancellations, disclosures may be |                                   |
| made to guaranty agencies, to     |                                   |
| financial and educational         |                                   |
| institutions, or to federal or    |                                   |
| state agencies. To provide a      |                                   |
| standardized method for           |                                   |
| educational institutions to       |                                   |
| efficiently submit student        |                                   |
| enrollment status, disclosures    |                                   |
| may be made to guaranty agencies  |                                   |
| or to financial and educational   |                                   |
| institutions. To counsel you in   |                                   |
| repayment efforts, disclosures    |                                   |
| may be made to guaranty agencies, |                                   |
| to financial and educational      |                                   |
| institutions, or to federal,      |                                   |
| state, or local agencies.         |                                   |
|                                   |                                   |
| In the event of litigation, we    |                                   |
| may send records to the           |                                   |
| Department of Justice, a court,   |                                   |
| adjudicative body, counsel,       |                                   |
| party, or witness if the          |                                   |
| disclosure is relevant and        |                                   |
| necessary to the litigation. If   |                                   |
| this information, either alone or |                                   |
| with other information, indicates |                                   |
| a potential violation of law, we  |                                   |
| may send it to the appropriate    |                                   |
| authority for action. We may send |                                   |
| information to members of         |                                   |
| Congress if you ask them to help  |                                   |
| you with federal student aid      |                                   |
| questions. In circumstances       |                                   |
| involving employment complaints,  |                                   |
| grievances, or disciplinary       |                                   |
| actions, we may disclose relevant |                                   |
| records to adjudicate or          |                                   |
| investigate the issues. If        |                                   |
| provided for by a collective      |                                   |
| bargaining agreement, we may      |                                   |
| disclose records to a labor       |                                   |
| organization recognized under 5   |                                   |
| U.S.C. Chapter 71. Disclosures    |                                   |
| may be made to our contractors    |                                   |
| for the purpose of performing any |                                   |
| programmatic function that        |                                   |
| requires disclosure of records.   |                                   |
| Before making any such            |                                   |
| disclosure, we will require the   |                                   |
| contractor to maintain Privacy    |                                   |
| Act safeguards. Disclosures may   |                                   |
| also be made to qualified         |                                   |
| researchers under Privacy Act     |                                   |
| safeguards.                       |                                   |
|                                   |                                   |
| **Paperwork Reduction Notice**    |                                   |
|                                   |                                   |
| According to the Paperwork        |                                   |
| Reduction Act of 1995, no persons |                                   |
| are required to respond to a      |                                   |
| collection of information unless  |                                   |
| it displays a currently valid OMB |                                   |
| control number. The valid OMB     |                                   |
| control number for this           |                                   |
| information collection is         |                                   |
| 1845-0005. The time required to   |                                   |
| complete this information         |                                   |
| collection is estimated to        |                                   |
| average 0.16 hours (10 minutes)   |                                   |
| per response, including the time  |                                   |
| to review instructions, search    |                                   |
| existing data resources, gather   |                                   |
| and maintain the data needed, and |                                   |
| complete and review the           |                                   |
| information collection. **If you  |                                   |
| have any comments concerning the  |                                   |
| accuracy of the time estimate(s)  |                                   |
| or suggestions for improving this |                                   |
| form, please write to:**          |                                   |
|                                   |                                   |
| U.S. Department of Education,     |                                   |
| Washington, DC 20202-4537         |                                   |
|                                   |                                   |
| **If you have questions regarding |                                   |
| the status of your individual     |                                   |
| submission of this form, write    |                                   |
| directly to the address shown in  |                                   |
| Section 7.**                      |                                   |
+-----------------------------------+-----------------------------------+