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 EDU

EDUCATION RELATED 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

This deferment request form covers four different deferments. Carefully review the information for each deferment 

type to determine whether you qualify for that deferment.

1. Interest will not accrue on your subsidized loan(s) 

during deferment. However, interest will accrue on 

your unsubsidized loan(s). You may pay the interest 

that accrues on your unsubsidized loan(s) during 

deferment. If you do not pay this interest, it will 

capitalize. Do you wish to make interest payments on 

your unsubsidized loan(s) during deferment?

Yes – Continue with the remainder of this section.

No – Continue with the remainder of this section.

PART A. GRADUATE FELLOWSHIP DEFERMENT

2. Do you hold a bachelor’s degree from an institution of 

higher education?

Yes – Continue to Item 3.

No – You are not eligible this deferment.

3. Have you been accepted or recommended by an 

institution of higher education for acceptance into a

graduate fellowship program on a full-time basis?

Yes – Continue to Item 4.

No – You are not eligible this deferment.

4. Does your graduate fellowship program provide 

sufficient financial support to allow for full-time study 

for a period of at least 6 months?

Yes – Continue to Item 5.

No – You are not eligible this deferment.

5. Does your graduate fellowship program require, 

before the awarding of financial support, a written 

statement from you that explains your objectives?

Yes – Continue to Item 6.

No – You are not eligible this deferment.

6. Does your graduate fellowship program require you to 

submit periodic reports, projects, or other evidence of 

your progress?

Yes – Continue to Item 7.

No – You are not eligible this deferment.

7. Are you studying at a foreign university?

Yes – Continue to Item 8.

No – Have an authorized official complete Section 

3 and then continue to Section 4. 

8. Will your graduate fellowship program accept the 

course of study from the foreign university for 

completion of the fellowship program?

Yes – Have an authorized official complete Section 

3 and then continue to Section 4.

No – You are not eligible this deferment.
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Borrower Name: ______________________________ Borrower SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 2: DEFERMENT REQUEST (CONTINUED)

PART B. REHABILITATION TRAINING DEFERMENT

9. Is your training program licensed, approved, certified, 

or recognized as providing rehabilitation training to 

disabled individuals by the Department of Veterans 

Affairs or a state agency responsible for the treatment 

of drug abuse, mental health, or alcohol abuse?

Yes – Continue to Item 0.

No – You are not eligible this deferment.

10. Does your training program provide services under a 

written, individualized plan that specifies the date the 

services are expected to end?

Yes – Continue to Item 11.

No – You are not eligible this deferment.

11. Does your program require a substantial commitment 

by you to your rehabilitation? Substantial 

commitment means a commitment of time and effort 

that would normally prevent a person from being 

employed 30 or more hours per week.

Yes – Continue to Item 12.

No – You are not eligible this deferment.

12. Are you receiving or scheduled to receive drug abuse, 

treatment, mental health services, or alcohol abuse 

treatment rehabilitation services?

Yes – Have an authorized official complete Section 

3 and then continue to Section 4.

No – You are not eligible this deferment.

PART C. INTERNSHIP/RESIDENCY DEFERMENT.

Maximum eligibility for this deferment is 24 months.

Before you complete Part C, read the additional eligibility 

information in Section 8.

13. Have you been accepted to an internship/residency 

program?

Yes – Continue to Item 14.

No – You are not eligible this deferment.

14. Did your program require, as a condition of admission, 

that you have a bachelor’s degree from an institution 

of higher education?

Yes – Continue to Item 15.

No – You are not eligible this deferment.

15. Is your internship/residency program a program in 

which you will receive training under supervision?

Yes – Continue to Item 16.

No – You are not eligible this deferment.

16. Will completion of this 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 – Have an authorized official complete Section 

3 and then continue to Section 4.

No – Continue to Item 17.

17. Will completion of the program be required by you 

can begin professional practice or service?

Yes – Have an authorized official complete Section 

3 and then continue to Section 4. You must also 

attach a separate statement form the appropriate 

state licensing agency certifying this requirement.

No – You are not eligible this deferment.

PART D. TEACHER SHORAGE AREA DEFERMENT

Maximum eligibility for this deferment is 36 months.

Before you complete Part D, read the additional eligibility 

information in Section 8.

18. Do you teach full time in a public or not-for-profit 

private elementary or secondary school?

Yes – Continue to Item 19.

No – You are not eligible this deferment.

19. Do you teach in a geographic region or specific grade 

level, academic, instructional, subject matter, or 

discipline classification that has been designated as a 

shortage area by the U.S. Department of Education?

If you are unsure, contact your Chief School 

Administrative or Chief State School Officer for 

confirmation.

Yes – Have an authorized official complete Section 

3 and then continue to Section 4.

No – You are not eligible this deferment.

If you previously received this deferment, but your 

area is no longer designated as a shortage area, check 

“yes”.
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Borrower Name: ______________________________ Borrower SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 3: AUTHORIZED OFFICIAL’S CERTIFICATION

Note: As an alternative to completing this section, you may attach separate documentation from an authorized 

official that includes all of the information requested below.

20. Did the borrower select “yes” in Items 8, 11, 17, or 

19?

Yes – Complete Items 21 through 22.

No – Do not complete this section.

21. The program/service begins/began on:

___ ___ - ___ ___ - ___ ___ ___ ___

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

___ ___ - ___ ___ - ___ ___ ___ ___

23. Did the borrower select “yes” in Item 19?

Yes – Complete Items 23 through 28.

No – Skip to Item 29.

24. Shortage area (geographic area/curriculum) in which 

the borrower is/was teaching:

____________________________________________

25. The shortage area was designated by the U.S. 

Department of Education for the state of: __________

26. The borrower is/was teaching in the shortage area for 

the school year that began on:

___ ___ - ___ ___ - ___ ___ ___ ___

27. The borrower is/was teaching in the shortage area for 

the school year that ends on:

___ ___ - ___ ___ - ___ ___ ___ ___

28. During the time periods described by Items 26 and 27, 

the borrower is/was teaching grade level:

____________________________________________

29. Did the borrower select “yes” to Item 17?

Yes – Complete Item 30. Read the certification 

below and complete Items 31 through 38.

No – Read the certification below and complete

Items 31 through 38.

30. Provide the name of the borrower’s 

internship/residency program:

___________________________________________

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

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

 That the borrower and the service meet all conditions indicated by the borrower’s responses in Section 2; and 

 The information that I have provided in Section 3 is accurate.

31. Name of Institution:______________________________________________________________________________

32. Address:________________________________________________________________________________________

33. Name/Title:_____________________________________________________________________________________

34. Signature:______________________________________________________________________________________

35. OPEID (if applicable):______________________________________________________________________________

36. City, State, Zip Code:_______________________________________________ , ____________ _________________

37. Telephone: ( ________ ) ________ - ______________

38. Date: ___ ___ - ___ ___ - ___ ___ ___ ___
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Borrower Name: ______________________________ Borrower SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 4: BORROWER REQUEST, UNDERSTANDINGS CERTIFICATIONS, AND AUTHORIZATION

I request to defer repayment of my loans for the period during which I meet the eligibility criteria outlined in Section 2.

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 the program or teaching service that qualifies for the deferment began, as 

certified by the authorized official.

3. My deferment will end on the earlier of the date that I am no longer in the program or teaching service, or the 

ending date as certified by the authorized official.

4. 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.

5. 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 requires 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 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. An authorized official must either complete Section 4 or attach the organization’s own signed certification 

listing the required information. 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.

SECTION 6: WHERE TO SEND THE COMPLETED FORM

Return the completed form to: If you need help completing this form, call:
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SECTION 7: DEFINITIONS

An authorized official who may complete Section 

3 is either: (1) an official of the Graduate Fellowship 

Program, Rehabilitation Training Program, or 

Internship/Residency Program; or (2) the Chief School 

Administrator (if you are teaching in teacher shortage 

areas, additional certification may be required if the Chief 

State School Officer has not provided a list of approved 

shortage areas to school administrators). 

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.

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 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 8: ELIGIBILITY REQUIREMENTS

For the graduate fellowship deferment (Section 2, 

Part A), you are only eligible for the deferment if you 

answer “yes” in Items 2 – 6, and, as applicable, “yes” in 

Item 8.

For the rehabilitation training deferment (Section 

2, Part B), you are only eligible for the deferment if you 

answer “yes” in Items 9 – 12.

For the internship/residency deferment (Section 2, 

Part C), you are only eligible for the deferment if, in 

addition to meeting the criteria below, you answer “yes” in 

Items 13 – 15 and you answer “yes” in Item 16 or 17.

For the teacher shortage area deferment (Section 

2, Part D), you are only eligible for the deferment if, in 

addition to meeting the criteria below, you answer “yes” in 

Items 18 and 19.

For the internship/residency deferment and the 

teacher shortage area deferment only, you are only 

eligible if, in addition to meeting the criteria above, you:

 Are a Direct Loan borrower who had an 

outstanding balance on a FFEL Program loan that 

was first disbursed before July 1, 1993 when you 

obtained your first Direct Loan; or

 Are a FFEL Program borrower who had an 

outstanding balance on a FFEL Program loan that 

was first disbursed before July 1, 1993 when you 

received a FFEL Program loan on or after July 1, 

1993.

For the internship/residency deferment only, in 

addition to meeting the criteria above, Federal PLUS Loans 

are only eligible for this deferment if the loan was 

disbursed before August 15, 1983. Federal Consolidation 

Loans are not eligible for this deferment.

SECTION 9: 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 

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 
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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 6).