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### RPS 

# REPAYMENT PLAN REQUEST: **Standard Repayment Plan/Extended Repayment Plan/Graduated Repayment Plan William D. Ford Federal Direct Loan (Direct Loan) Program**  OMB No. 1845

-0014 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 **: REPAYMENT PLAN REQUEST**  **1. Choose one of the following:**  I want to select a plan for all of my Direct Loans

. I want to select a plan for only my Direct Loans that are not eligible for the Income

- Based Repayment (IBR), Pay As You Earn, or Income

-Contingent Repayment (ICR) Plan. The following loans are n ot eligible for these plans :
 Direct Parent PLUS Loans : not eligible for IBR, Pay As You Earn, or ICR.

 Direct Consolidation Loans made on or after July 1, 2006 that repaid Direct Parent PLUS Loans or Federal Parent PLUS Loans: not eligible for IBR or Pay As You Earn

. These loans are eligible for ICR

.  Direct Consolidation Loans made before July 1, 2006 that repaid Direct Parent PLUS Loans or Federal Parent PLUS Loans (these are called “Direct PLUS Consolidation Loans”) : not eligible for IBR, Pay As You Earn, or ICR

. **2. Check the box for the repayment plan that you wish to select:**  These plans are described in Section 5. Sample payment amounts for eac h plan are provided in Section 7

. Standard Graduated Extended

– Fixed Paym ents Extended

– Graduated Payments **Note** : If you are interested in the IBR, Pay As You Earn, or ICR plan, visit StudentLoans.gov to read or complete the application or StudentAid.gov to learn more. To help you compare these plans to the Standard, Graduated, and Extended plans, sample payments amounts for the IB R, Pay As You Earn, and ICR plans are provided in Section 7

. 

### S**ECTION 3 :**  **BORROWER UNDERSTANDINGS, CERTIFICATION S** **, 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 IBR, Pay As You Earn, or 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 und er those plans, 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 re paym ent plan I selected in Section 2 . 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 terms of the repayment plan that I requested in Section 2, as explained in Sections 5 and 7

.  **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 o r other wireless device using automated telephone dialing equipment or artificial or prerecorded voice or text messages.

**Borrower Signature** 

____ ______________________ _ _ _____ _________

___ __ **Date**

___ ___ - ___ _

__ -

_ _ _ _ _ _ _ _ _ ___Page 2 of 5 

### SECTION 4**: INSTRUCTIONS FOR COMPLETING THE FORM**  Type or print using dark ink. Enter dates as month

-day

-year (mm

-dd

-yyyy). Use only nu mbers. Example: January 31, 2013 = 01

-31

-2013 . 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 t o the address shown in Section 6** 

**.**


### SECTION 5 **: REPAYMENT PLAN DESCRIPTIONS STANDARD REPAYMENT PLAN**  Under this plan, you will pay a fixed amount each month over the course of your maximum repayment period in an amount that will ensure that your loan is fully repaid by the e nd of your repayment period . This plan may result in lower total interest paid when compared to other plans. For Direct Subsidized Loans, Direct Unsubsidized Loans, and Direct PLUS Loans, the maximum repayment period is 10 years. For Direct Consolidation Loans, the maximum repayment period ranges from 10 to 30 years, depending on loan debt.

**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. Your payment amount will ensure that your loan is fully repaid by the end of you r repayment period. 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. For Direct Subsidized Loans, Direct Unsubsidized Loans, and Direct PLUS Loans, the maximum repayment period is 10 years. For Direct Consolidation Loans, the maximum repayment period ranges from 10 to 30 years, depending on loan debt. **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. Your payment amount will ensure that your loan is fully repaid by the end of your repayment period. If you choose 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 lo nger repayment period, you will pay more interest over the life of your loans.

 For all loan types, the maximum repayment period is 25 years.

**See Section 7 for sample repayment amounts under each of these repayment plans.** 


### SECTION 6 **: WHERE TO SEND THE COMPLETED REPAYMENT PLAN**  **REQUEST** Return the completed form and any required documentation to: (If no address is shown, return to your loan servicer.) If you need help completing this form, call: (If no telephone number is shown, call your loan servicer.)Page 3 of 5 

### SECTION 7 **: 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, inclu ding your actual interest rate and the amount of your loan debt, 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. **Direct Subsidized Loans, Direct Unsubsidized Loans, and Direct PLUS Loans**

Debt 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 $20,000 $245 $29,437 $144 $431 $32,177 Not Eligible

- Not Eligible

- - $30,000 $368 $44,155 $216 $647 $48,265 Not Eligible

- Not Eligible

- - $40,000 $491 $58,873 $287 $862 $64,353 $315 $94,614 $275 $417 $101,515 $50,000 $613 $73,592 $359 $1,078 $80,442 $394 $118,268 $344 $521 $126,899 $60,000 $736 $88,310 $431 $1,294 $96,530 $473 $141,921 $413 $625 $152,280 $70,000 $859 $103,028 $503 $1,509 $112,618 $552 $165,575 $481 $730 $177,664 $80,000 $981 $117,747 $575 $1,725 $128,706 $631 $189,228 $550 $834 $203,046 $90,000 $1,104 $132,465 $647 $1,940 $144,795 $710 $212,882 $619 $938 $228,427 All payments are calculated using a fixed interest rate of 8.25%, which is the maximum interest rate on Direct Subsidized and Unsubsidized Loans for undergraduate students.
**Direct Consolidation Loans** 

Debt Standard (10

-30 years) Graduated (10

-30 years) Extended

- Fixed (25 yrs. ) 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 $20,000 20 years $170 $40,899 20 years $138 $241 $44,420 Not Eligible

- Not Eligible

- - $30,000 20 years $256 $61,349 20 years $206 $362 $66,631 Not Eligible

- Not Eligible

- - $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 $228,427 All payments are calculated using a fixed interest rate of 8.25%.Page 4 of 5 

### SECTION 7 **: SAMPLE PAYMENT AMOUNTS (CONTINUED)**  Below are three tables that provide examples of monthly payment amounts under the IBR, Pay As You Earn, and ICR plans . The figures provided in these tables are estimates, and use an interest rate of 8.25%. Various factors, including your actual interest rate, the amount of your loan debt, your income, and whether and how quickly it rises (these figures assume a rate of increase of 5% per year), may cause your payment amount to differ from the monthly payment amounts shown in these tables.
**Income**
**- Based Rep** **ayment (IBR) Plan**

Debt Starting income of $25,000 Starting income of $40,000 Starting income of $60,000

Initial Payment Final

Payment Total

Paid Time to Repay ( Mos. ) Initial

Payment Final

Payment Total

Paid Time to

Repay ( Mos. ) Initial

Payment Final

Payment Total

Paid Time to Repay ( Mos. ) $20,000 $97 $245 $45,835 240 Not Eligible

- - - Not Eligible

- - - $40,000 $97 $491 $80,171 300 $285 $491 $74,134 179 Not Eligible

- - - $60,000 $97 $538 $80,919 300 $285 $736 $155,029 283 $535 $736 $97,632 145 $80,000 $97 $538 $80,919 300 $285 $981 $184,670 300 $535 $981 $158,503 198 $100,000 $97 $538 $80,919 300 $285 $1,143 $188,307 300 $535 $1,227 $241,490 259 **Pay As You Earn Plan**

Debt Starting income of $25,000 Starting income of $40,000 Starting income of $60,000

Initial Payment Final

Payment Total

Paid Time to

Repay ( Mos. ) Initial

Payment Final

Payment Total

Paid Time to Repay ( Mos. ) Initial

Payment Final

Payment Total

Paid Time to

Repay ( Mos. ) $20,000 $65 $245 $34,735 240 $190 $245 $31,449 136 Not Eligible

- - - $40,000 $65 $260 $34,914 240 $190 $491 $82,552 240 $356 $491 $65,087 145 $60,000 $65 $260 $34,914 240 $190 $576 $84,514 240 $356 $736 $131,919 229 $80,000 $65 $260 $34,914 240 $190 $576 $84,514 240 $356 $981 $150,454 240 $100,000 $65 $260 $34,914 240 $190 $576 $84,514 240 $356 $997 $150,647 240
**Income**
**- Contingent Repayment (ICR) Plan** 

Debt Starting income of $25,000 Starting income of $40,000 Starting income of $60,000

Initial Payment Final

Payment Total

Paid Time to

Repay ( Mos. ) Initial

Payment Final

Payment Total

Paid Time to

Repay ( Mos. ) Initial

Payment Final

Payment Total

Paid Time to

Repay ( Mos. ) $20,000 $151 $189 $43,755 253 $193 $217 $33,978 168 $219 $244 $30,930 134 $40,000 $225 $420 $99,772 286 $385 $434 $67,957 168 $438 $489 $61,860 134 $60,000 $225 $676 $140,178 300 $475 $666 $108,859 184 $658 $733 $92,790 134 $80,000 $225 $926 $151,474 300 $475 $956 $179,997 238 $809 $978 $125,235 137 $100,000 $225 $926 $151,474 300 $475 $1,372 $280,318 300 $809 $1,243 $173,158 162Page 5 of 5 

### SECTION **8 : IMPORTANT NOTICES**  **Privacy Act Notice.** The Privacy Act of 1974 (5 USC 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. , §451 et seq. , and/or §461 et seq. of the Higher Education Act (HEA) of 1965, as amended ( 20 USC 1071 et seq. , 20 USC 1087a et seq. , and/or 20 USC 1087aa et seq. ), and the authorities for collecting and using your Social Security Number (SSN) are §484(a)(4) of the HEA (20 USC 1091(a)(4)) and 31 USC 7701(b). Participating in the Federal Family Education Loan (FFEL) Program, William D. Ford Federal Direct Loan (Direct Loan) Program, and Federal Perkins Loan (Perkins) Program and giving us your SSN are voluntary, but you must provide the requested information, including your SSN, to participate. The p rincipal 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 F FEL Program, Direct Loan Program, and/or Perkins 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) become delinquent or in default. We also use your SSN a s 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 t he 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 progra m 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 USC 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 disp lays a currently valid OMB control number. Public reporting burden for this collection of information is estimated to average 0.5 hours (30 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 loan**  **servicer (see Section**  **6)**

**.**