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UNEM

UNEMPLOYMENT DEFERMENT REQUEST

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

Education Loan (FFEL) Program

OMB No. 1845-0011

DRAFT FORM

Exp. Date XX/XX/XXXX

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 IDENTIFICATION

Please enter or correct the following information. 

Check this box if any of your information has changed. 

SSN

Name

Address

City, State, Zip

Telephone – Primary

Telephone – Alternate

E-mail (optional)

___ ___ ___ - ___ ___ - ___ ___ ___ ___

___________________________________________

___________________________________________

________________________ , _______ __________

( ___________ ) ___________ - _________________

( ___________ ) ___________ - _________________

___________________________________________

SECTION 2: DEFERMENT ELIGIBILITY

Maximum eligibility is 36 months for Direct Loan and FFEL Program borrowers except for FFEL Program borrowers 

whose first FFEL Program loan was first disbursed before July 1, 1993, whose maximum eligibility is 24 months.

1. Interest that accrues on unsubsidized loans during 

deferment will capitalize at the end of the deferment. 

Would you like to make interest payments on your 

unsubsidized loans during the deferment?

Yes – Continue to Item 2.

No – Continue to Item 2.

2. Are you receiving unemployment benefits?

If you answer yes, you must attach documentation of 

your eligibility for these benefits which includes your 

name, address, and Social Security Number, and which 

shows that you are eligible to receive the benefits for 

the period of time for which you are requesting a 

deferment.

Yes – Skip to Item 9

No – Continue to Item 3.

3. Are you diligently seeking full-time employment in the 

United States?

Yes – Continue to Item 4.

No – You are not eligible for this deferment.

4. Have you rejected offers of full-time employment in 

the United States in any field or at any salary or 

responsibility level?

Yes – You are not eligible for this deferment.

No – Continue to Item 5.

5. Is this an extension of a previously granted 

Unemployment Deferment?

Yes – Continue to Item 6.

No – Skip to Item 7.

6. Have you made at least six diligent attempts to find 

full-time employment in the most recent 6 months?

Yes – Continue to Item 7.

No – You are not eligible for this deferment.

7. Is there a public or private employment agency within 

50 miles of your current address? 

School placement offices, temporary employment 

agencies, and Web sites that allow users to search for 

or apply for employment do not qualify.

Yes – Continue to Item 8.

No – Skip to Item 9.

8. Have you registered with the public or private 

employment agency?

Yes – Continue to Item 9.

No – You are not eligible for this deferment.

9. When did you become unemployed?

___ ___ - ___ ___ - ___ ___ ___ ___

10. Do you want your deferment to begin later than the 

date on which you became unemployed?

Yes – Continue to Item 11.

No – Skip to Section 3.

11. When do you want your deferment to begin?

___ ___ - ___ ___ - ___ ___ ___ ___

Continue to Section 3.
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Borrower Name: ______________________________ Borrower SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 3: BORROWER REQUEST, UNDERSTANDINGS CERTIFICATIONS, AND AUTHORIZATION

I request that my loan holder deferment repayment on my loans while I am unemployed.

I understand that:

1. I am not required to make payments of loan principal or interest during my deferment.

2. My deferment will begin on the date I specified in Items 9 or 11 in Section 2 unless I selected “no” to Item 5 in 

Section 2, in which case my deferment will begin no earlier than 6 months prior to my loan holder’s receipt of 

this deferment request.

3. My deferment will end on the earlier of the date I obtain full-time employment or the date on which I exhaust 

my maximum cumulative eligibility.

4. My deferment will only be granted in 6-month increments and I must reapply for the deferment if I want to 

extend my deferment.

5. Maximum cumulative eligibility 

6. If my deferment does not cover all my past due payments, my loan holder may grant a forbearance for all 

payments due before the begin date of my deferment.

7. My loan holder may grant a forbearance for up to 60 days for the collection and processing of documentation 

related to my deferment request. Interest that accrues during this forbearance will not be capitalized.

I certify that: 

1. The information I have provided on this form is true and correct.

2. I will provide additional documentation to my loan holder, as required, to support my deferment status.

3. I will notify my loan holder immediately when my qualification for the deferment ends.

4. I have read, understand, and meet the eligibility requirements of the deferment for which I have applied.

I authorize the entity to which I submit this request (i.e., the school, the lender, the guaranty agency, the U.S. 

Department of education, and their respective agents and 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 ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 4: WHERE TO SEND THE COMPLETED FORM

Return the completed form to: If you need help completing this form, call:

SECTION 5: INSTRUCTIONS

Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: March 14, 2015 

= 03-14-2015. Include your name an account number on any documentation that you are required to submit with this 

form. If you need help completing this form, contact your loan holder. If you want to apply for a deferment on loans that 

are held by different loan holders, you must submit a separate deferment request to each loan holder.
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SECTION 6: DEFINITIONS

Capitalization is the addition of unpaid interest to 

the principal balance of your loan. As a result of 

capitalization, more interest may accrue over the life of 

the loan and the monthly payment amount may be higher. 

The chart below (Table 1) provides estimates, for a 

$15,000 unsubsidized loan balance at a 6.8% interest rate, 

of the monthly payments due following a 12-month 

deferment that started when the loan entered repayment. 

It compares the effects of paying the interest as it accrues, 

capitalizing the interest at the end of the deferment, and 

capitalizing interest quarterly and at the end of the 

deferment. Please note that the U.S. Department of 

Education (the Department) and many other holders do 

not capitalize interest on a quarterly basis. The actual loan 

interest cost will depend on your interest rate, length of 

the deferment, and frequency of capitalization.

A deferment is a period during which you are 

entitled to postpone repayment of the principal balance of 

your loan(s). Interest does not accrue during a deferment 

on a Direct Subsidized Loan, a Direct Subsidized 

Consolidation Loan, a subsidized Federal Stafford Loan, or, 

in some cases, the subsidized portion of a Federal 

Consolidation Loan (see Note). Interest does accrue during 

a deferment on a Direct Unsubsidized Loan, a Direct PLUS 

Loan, a Direct Unsubsidized Consolidation Loan, an 

unsubsidized Federal Stafford Loan, a Federal PLUS Loan, 

or a Federal SLS Loan. Note: Interest does not accrue on a 

Federal Consolidation Loan during a deferment only if: (1) 

the application for the loan was received by your loan 

holder on or after January 1, 1993, but before August 10, 

1993; (2) the application was received by your loan holder 

on or after August 10, 1993, and the loan includes only 

subsidized Federal Stafford Loans; or (3) the application 

was received by your loan holder on or after November 

13, 1997, in which case interest does not accrue on the 

portion of the Federal Consolidation Loan that paid a 

subsidized Direct Loan or FFEL Program loan(s).

The Federal Family Education Loan (FFEL) 

Program includes Federal Stafford Loans, Federal PLUS 

Loans, Federal Consolidation Loans, and Federal 

Supplemental Loans for Students (SLS). 

A forbearance is a period during which you are 

permitted to temporarily postpone making payments, 

allowed an extension of time for making payments, or 

temporarily allowed to make smaller payments than 

scheduled.

Full-time employment is defined as working at 

least 30 hours per week in a position expected to last at 

least 3 consecutive months.

The holder of your Direct Loan Program loan(s) is 

the Department. The holder of your FFEL Program loan(s) 

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

the Department.

The United States, for the purpose of this 

deferment, includes any state of the Union, the District of 

Columbia, the Commonwealth of Puerto Rico, American 

Samoa, Guam, the Virgin Islands, the Commonwealth of 

the Northern Mariana Islands, the Freely Associated States 

(the Republic of the Marshall Islands, the Federated States 

of Micronesia, and the Republic of Palau), and U.S. military 

bases and embassy compounds in foreign countries.

The William D. Ford Federal Direct Loan (Direct 

Loan) Program includes Federal Direct Stafford/Ford 

(Direct Subsidized) Loans, Federal Direct Unsubsidized 

Stafford/Ford (Direct Unsubsidized) Loans, Federal Direct 

PLUS (Direct PLUS) Loans, and Federal Direct 

Consolidation (Direct Consolidation) Loans.

Table 1. Capitalization Chart

Treatment of Interest Accrued 

During Deferment

Loan

Amount

Capitalized 

Interest Principal Monthly Pmt.

Num. 

Pmts.

Total 

Repaid

Total 

Interest 

Paid

Interest is paid $15,000.00 $0.00 $15,000.00 $172.62 120 *$21,736.55 $6,730.66

Interest is capitalized at the end of 

deferment $15,000.00 $1,022.09 $16,022.09 $184.38 120 $22,125.94 $7,119.64

Interest is capitalized quarterly 

during deferment and at the end 

of deferment

$15,000.00 $1,048.51 $16,048.51 $184.69 120 $22,162.41 $7,156.10

*Total amount repaid includes $1,022.09 of interest paid during the 12-month period of deferment.
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SECTION 7: 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 authorities for collecting the requested information 

from and about you are §421 et seq. and §451 et seq. of 

the Higher Education Act of 1965, as amended (20 U.S.C. 

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

authorities for collecting and using your Social Security 

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

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

Participating in the Federal Family Education Loan (FFEL) 

Program or 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 FFEL and/or Direct Loan Programs, 

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 caseby-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 such 

collection displays a valid OMB control number. The valid 

OMB control number for this information collection is 

1845-0011. Public reporting burden for this collection of 

information is estimated to average 10 minutes per 

response, including time for reviewing instructions, 

searching existing data sources, gathering and maintaining 

the data needed, and completing and reviewing the 

collection of information. The obligation to respond to this 

collection is required to obtain a benefit in accordance 

with 34 CFR 682.210 or 685.204. If you have comments or 

concerns regarding the status of your individual 

submission of this form, please contact your loan holder

directly (see Section 4).