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## MANDATORY FORBEARANCE REQUEST **STUDENT LOAN DEBT BURDEN William D** **. Ford Federal Direct Loan (Direct Loan) Program**  **/ Federal Family Education Loan (FFEL) Program**  OMB No . 1845 -0018 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 su bject 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: FORBEARANCE**  **ELIGIBILITY Maximum eligibility is 36 months.**  As an alternative to this forbearance, you may qualify for a deferment or for a repayment plan that determines your monthly payment amount based on your income. Contact your loan holder for more information. If you are an endorser, you may request forbearance only when you are required to repay the loan because the borrower is not making payments. If you are requesting forbearance on a loan that was made jointly to you and your spouse ( as comakers ), both you and the other borrower must individual ly meet the requirements for a forbearance and each of you must submit a separate forbearance request. **1.** Check the type of forbearance you would like to receive : Stop making payments – Continue to Item 2 Make smaller payments in the amount of $____________ per month – Skip to Item 3 . **2.** I nterest will accrue o n your l oan(s) during forbearance . You may pay the interest that accrues on your these loan(s) during forbearance . If you do not pay this interest, it will capitalize. Do you wish to make interest payments on your loan(s) during forbearance ? Yes – Continue to Item 3 . No – Continue to Item 3 . **3.** What is your total monthly income ? $

__ _____________. You must attach documentation of your monthly income unless you have no income . Monthly income is either (you choose):  Your gross taxable income from all sources; or  One-twelfth of the Adjusted Gross Income from your most recent federal income tax return. **4.** Multiply the amo unt in Item 1 by 20% (0.20) : $

__ _____________. **5.** What is the total amount of your monthly payments on all of your Title IV loans? $

__ _____________. You must attac h documentation of your most recent monthly payments due on all of your Title IV loans. **6.** Is the amount reported in Item 5 equal to or greater than the amount calculated in Item 4? Yes – Continue to Item 7 . No – You are not eligible for this forbearance. **7.** When would you like this forbearance to begin?

___ ___ - ___ ___ - ___ ___ ___ ___ **8.** You may receive this forbearance in 12- month increments. Would you like this forbearance end earlier than 12 months after the date in Item 7 ? Yes – Continue to Item 9 . No – Skip to Section 3 . **9.** Provide the date on which you want the forbearance to end and then continue to Section 3 :

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### Borrower Name: ______________________________ Borrower SSN:

**___ ___**  **___ -**  **___ ___**  **- ___**  **___ ___**  **___ SECTION**  **3 :**  **BORROWER REQUEST,**  **UNDERSTANDINGS CERTIFICATIONS, AND AUTHORIZATION I request**  a forbearance while my monthly payments on my Title IV loans equal or exceed 20% of my total monthly income . **I understand that: 1.**  I am not required to make payments of loa n principal o r interest during my forbearance . **2.** My forbearance will begin on the date I specified in Item 7 . **3.** My forbearance will end on the earlier of the date I am no longer eligible for the forbearance, 12 months from the date indicated in Item 7, or the date I indicated in Item 9 . **4.** My forbearance will only be granted in 12 - month increments and I must reapply for the forbearance if I continue to meet the eligibility requirements and want to extend my forbearance **5.** Maximum cumulative eligibility is 36 months. **6.** If my forbearance 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 forbearance . **7.** My loan holder may grant a forbearance for up to 60 days for the collection and processing of documentation related to my forbearance 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 forbearance status. **3.** I will not ify my loan holder immediate ly when my qualification for the forbearance e nds. **4.** I have read, understand, and meet the eligibility require m ents of the forbearance 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 forbearance on loans that are held by different loan holders, you must submit a separate forbearance request to each loan holder.Page 3 of 4 **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 forbearance that started when the loan entered repayment. It compares the effects of paying the interest as it accrues, ca pitalizing the interest at the end of the forbearance, and capitalizing interest quarterly and at the end of the forbearance . 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 forbearance, a nd frequency of capitalization. A **comaker** is one of the two individual who are joint borrowers on a Direct or Federal Consolidation Loan or a Federal PLUS Loan. Both coma kers are equally responsible for repaying the full amount of the loan. An **endorser** is an individual who signs a promissory note and agrees to pay the loan if the borrower does not. The **Federal Family Education Loan (FFEL) Program**  includes Federal Stafford Loans, Federal PLUS Loans, Federal Consolidation Loans, and Federal Supplemental Loans for Students (SLS). The **Federal Perkins Loan (Perkins Loan) Program** includes Federal Perkins Loans, National Direct Student Loans (NDSL), and National Defense Student Loans (Defense Loan). A **forbearance** is a period of time during which you are allowed to temporarily postpone making payments, allowed an extension of time for making payments, or temporarily allows to make smaller payments than scheduled. A forbearance can be a mandatory forbearance, meaning that your loan holder must grant the forbearance if you qualify for the forbearance and supply all supporting documentation. A forbearance can also be a discretionary forbearance, meaning that your loan holder may grant the forbearance, but is not required to do so. 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. **Title IV loans** are student loans that are made under the FFEL Program, Perkins Loan Program, and the Direct Loan Program. The **William D. Ford Federal Direct Loan (Direct Loan) Program**  includes Federal Direct Stafford/Ford (Direct Subsidized) Loans, Federal Direct Unsubsi dized 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**  **Forbearance 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 forbearance $15,000.00 $1,022.09 $16,022.09 $184.38 120 $22,125.94 $7,119.64 Interest is capitalized quarterly during forbearance 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 forbearance .Page 4 of 4 **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 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 gua ranty 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 age ncies, 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 De partment 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 re levant 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 safegu ards . **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 -001 8 . Public reporting burden for this collection of information is estimated to average 1 2 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. 211 or 685. 205 . 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) .