RPS

REPAYMENT PLAN SELECTION: 

Standard Repayment Plan/Graduated Repayment Plan/Extended Repayment Plan

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

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.

SECTION 1: BORROWER IDENTIFICATION

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 ( )

E-mail Address (Optional)

SECTION 2: REPAYMENT PLAN DESCRIPTIONS

If you choose... ...and you have... ...your minimum 

monthly payment 

will be...

...and your

maximum 

repayment period 

will be...

...the Standard 

Repayment Plan...

...Direct Subsidized, 

Unsubsidized, or PLUS 

Loans...

...$50... ...10 years.

...Direct Consolidation 

Loans... ...$50... ...10-30 years (see below).

...the Graduated 

Repayment Plan...

...Direct Subsidized, 

Unsubsidized, or PLUS 

Loans...

...monthly 

interest... ...10 years.

...Direct Consolidation 

Loans...

...monthly 

interest...

...10-30 years (see 

below).

...the Extended 

Repayment Plan –

Fixed Payments...

...any type of Direct 

Loan... ...$50. ...25 years.

...the Extended 

Repayment Plan –

Graduated Payments...

...any type of Direct 

Loan...

...monthly 

interest... ...25 years.

Maximum Repayment Period for Direct Consolidation Loans under Standard and Graduated 

Repayment Plan

If your Total Education 

Loan Indebtedness is...

...your Maximum 

Repayment Period

At Least Less Than will be...

$7,500 10 years

$ 7,500 $10,000 12 years

$10,000 $20,000 15 years

$20,000 $40,000 20 years

$40,000 $60,000 25 years

$60,000 30 years

STANDARD REPAYMENT PLAN

Under this plan, you will pay a fixed amount each month over the 

course your maximum repayment period. This plan may result in 

lower total interest paid when compared to other plans.

GRADUATED REPAYMENT PLAN

Under this plan, your payments start out low and then increase every 

two years. No single payment under this plan will be more than three 

times greater than any other payment. Generally, the amount you will 

repay over the life of your loan will be higher under this plan than 

under the Standard Repayment Plan. This plan may be beneficial if 

your income is low now but is likely to steadily increase.

EXTENDED REPAYMENT PLAN

You may choose this plan only if (1) you had no outstanding balance 

on a Direct Loan on October 7, 1998 or on the date you obtained a 

Direct Loan after that date, and (2) you owe more than $30,000 in 

outstanding Direct Loans.

Under this plan, you have the option of making either fixed or 

graduated payments over your maximum repayment period. If you 

elect graduated payments, your payments start out low and then 

increase every two years.

Under either the fixed or graduated monthly payment option, the 

Extended Repayment Plan will give you a lower monthly payment on 

your non-consolidation loans than the Standard or Graduated 

Repayment Plans. However, because of the longer repayment period, 

you will pay more interest over the life of your loans.

If you have a Direct Consolidation Loan and owe more than $30,000 

but less than $40,000 in education loans, the Extended Repayment 

Plan will provide you with a longer repayment period than the 

Standard or Graduated Repayment Plans, but the total amount of 

interest you pay over the life of the loan may be more than under 

those plans.

SECTION 3: REPAYMENT PLAN REQUEST

Check the box for the repayment plan that you wish to select:

Standard Repayment Graduated Repayment Extended Repayment – Fixed Payments Extended Repayment – Graduated Payments

Note: If you want a repayment plan with a monthly payment amount that is based on your income, complete the Income-Based/Pay As You Earn/Income-Contingent 

Repayment Plan Request. If you have other loans that are not eligible for repayment under IBR, Pay As You Earn, or ICR plans (see below), you may select IBR, Pay As You Earn, 

or ICR for your eligible loans and repay your ineligible loans under a different plan.

Check this box if you have some loans that you wish to repay under the repayment plan selected above because those loans are not eligible for the IBR plan, the Pay As You 

Earn plan, or the ICR plan. The following loans are not eligible to be repaid under the IBR, Pay As You Earn, and/or ICR plans:

 Direct PLUS Loans made to parents of dependent undergraduates: not eligible for IBR, Pay As You Earn, or ICR.

 Direct Consolidation Loans that repaid Direct or Federal PLUS Loans made to parents of dependent undergraduates: not eligible for IBR or Pay As You Earn.

 Direct PLUS Consolidation Loans: not eligible for IBR, Pay As You Earn, or ICR

SECTION 4: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION

 I understand that: (1) I must choose the same repayment plan for all of my Direct Loans, unless I want to repay my loans under the Income-Based Repayment (IBR), Pay As 

You Earn, or Income Contingent Repayment (ICR) Plan and I have some loans that may not be repaid under those plans. In this case, I may select the IBR, Pay As You Earn, or 

ICR plan for the loans that are eligible for repayment under those plans by completing the IBR/Pay As You Earn/ICR Plan Request, and may select a different repayment plan 

for the loans that may not be repaid under IBR, Pay As You Earn, or ICR. (2) If I am beginning repayment of my loans for the first time and I do not select a repayment plan, I 

will be placed on the Standard Repayment Plan. (3) If I am delinquent in making payments under my current repayment plan at the time I request to change to a different 

plan, my servicer may grant me a forbearance to cover any payments that are overdue at the time I enter the repayment plan I selected in Section 3. Unpaid interest that 

accrues during this forbearance period may be capitalized at the end of the forbearance period.

 I certify that (1) The information I have provided on this form is true and correct and (2) I have read and understand the repayment plan that I requested, as explained in 

Section 2.

 I authorize the U.S. Department of Education (and its agents or contractors) to contact me regarding my request or my loan(s), including repayment of my loan(s), at the 

number that I provide on this form 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.

Borrower’s Signature Date

OMB No. 1845-0014

DRAFT Form

Exp. Date xx/xx/xxxx
SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM

Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: January 31, 2012 = 01-31-2012. If you need help completing this form, 

contact your federal loan servicer. If you want to apply for a repayment plan and your Direct Loans are serviced by different federal loan servicers, you must submit a separate 

repayment plan request to each loan servicer.

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

SECTION 6: SAMPLE PAYMENT AMOUNTS

Below are two tables that provide examples of monthly payment amounts under the Standard, Graduated, and Extended repayment plans. The figures provided in these tables 

are estimates. Various factors, including your actual interest rate, the amount of your loan debt, and whether you have used any of your repayment period, may cause your 

payment amount to differ from the monthly payment amounts shown in these tables. Your federal loan servicer will provide you with the actual monthly payment amount after 

you select a repayment plan.

Non-Consolidation Loans

Debt When Loan 

Enters Repayment

Standard (10 years) Graduated (10 years) Extended-Fixed (25 

years) Extended-Graduated (25 years)

Payment Total Paid Minimum 

Payment

Maximum 

Payment Total Paid Payment Total Paid Minimum Payment

Maximum 

Payment Total Paid

$10,000 $115 $13,810 $66 $199 $14,860 - - - - -

$20,000 $230 $27,619 $133 $398 $29,720 - - - - -

$30,000 $345 $41,429 $199 $598 $44,580 - - - - -

$40,000 $460 $55,239 $266 $797 $59,439 $278 $83,289 $227 $397 $90,207

$50,000 $575 $69,048 $332 $996 $74,300 $347 $104,111 $283 $496 $112,762

$60,000 $690 $82,858 $398 $1,195 $89,160 $416 $124,933 $340 $595 $135,314

$70,000 $806 $96,667 $465 $1,393 $104,020 $486 $145,755 $397 $694 $157,865

$80,000 $921 $110,477 $531 $1,593 $118,880 $555 $166,577 $453 $793 $180,427

$90,000 $1,036 $124,287 $597 $1,791 $133,740 $625 $187,399 $510 $892 $202,980

$100,000 $1,151 $138,096 $664 $1,991 $148,600 $694 $208,222 $567 $992 $225,531

All payments above are calculated using a fixed interest rate of 6.8 percent.

Consolidation Loans

Debt When 

Loan Enters 

Repayment

Standard (10-30 years) Graduated (10-30 years) Extended-Fixed (25 

years) Extended-Graduated (25 years)

Maximum 

Repayment 

Period

Payment Total 

Paid

Maximum 

Repayment 

Period

Minimum 

Payment

Maximum 

Payment 

Total 

Paid Payment Total Paid

Minimum 

Payment

Maximum 

Payment 

Total 

Paid

$10,000 15 years $97 $17,463 15 years $69 $163 $19,174 - - - - -

$20,000 20 years $170 $40,899 20 years $138 $241 $44,420 - - - - -

$30,000 20 years $256 $61,349 20 years $206 $362 $66,634 - - - - -

$40,000 25 years $315 $94,614 25 years $275 $417 $101,515 $315 $94,614 $275 $417 $101,515

$50,000 25 years $394 $118,268 25 years $344 $521 $126,899 $394 $118,268 $344 $521 $126,899

$60,000 30 years $451 $162.274 30 years $413 $549 $166,145 $473 $141,921 $413 $625 $152,280

$70,000 30 years $526 $189,319 30 years $481 $640 $193,841 $552 $165,575 $481 $730 $177,664

$80,000 30 years $601 $216,365 30 years $550 $732 $221,531 $631 $189,228 $550 $834 $203,046

$90,000 30 years $676 $243,410 30 years $619 $823 $249,228 $710 $212,882 $619 $938 $228,428

$100,000 30 years $751 $270,456 30 years $688 $915 $276,914 $789 $236,535 $688 $1,042 $253,806

All payments above are calculated using a fixed interest rate of 8.25 percent, which is the maximum interest rate on Direct Consolidation Loans.

SECTION 7: WHERE TO SEND THE COMPLETED REPAYMENT PLAN SELECTION

Return the completed form and any required documentation to:

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

If you need help completing this form, call:

(If no telephone number is shown, call your federal loan servicer.)
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 §451 et seq. of the Higher Education Act of 1965, as amended (20 U.S.C. 1087a 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 William D. Ford 

Federal Direct Loan (Direct Loan) Program 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 Direct Loan Program, 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 defaults. 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 statuses, 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. Public reporting burden for this collection of information is estimated to average 0.167 hours (10 minutes) per response, including the time for 

reviewing instructions, searching existing data resources, gathering and maintaining the data needed, and completing and reviewing the information collection. Individuals are 

obligated to respond to this collection to obtain a benefit in accordance with 34 CFR 685.208. Send comments regarding the burden estimate(s) or any other aspect of this 

collection of information, including suggestions for reducing this burden to the U.S. Department of Education, 400 Maryland Avenue, SW, Washington, DC 20210-4537 or e-mail 

ICDocketMgr@ed.gov and reference OMB Control Number 1845-0014. Note: Please do not return the completed form to this address.

If you have questions regarding the status of your individual submission of this form, contact your federal loan servicer (see Section 7).