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 SCRA

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: SCRA INTEREST RATE LIMITATION REQUEST

Before completing this form, carefully read the entire form, particularly Sections 4 and 5. Type or print using dark ink. If you need help completing 

this form, contact your loan holder(s). Return the completed form and any required documentation to the address shown in Section 6.

1. To be eligible for an interest rate limitation under the SCRA, you must be performing eligible military service. Please indicate the type of eligible 

military service you are performing by checking the appropriate box, below. You are performing eligible military service if you are:

A member of the U.S. Army, Navy, Air Force, Marine Corps, or Coast Guard on active duty under 10 USC 101(d)(1);

A member of the National Guard on active duty or full-time National Guard duty authorized by the President or the Secretary of Defense for a 

period of more than 30 consecutive days, for the purposes of responding to a national emergency declared by the President and supported by 

Federal funds, under 32 USC 502(f); or

A commissioned officer of the Public Health Service or the National Oceanic and Atmospheric Administration on active service.

If none of the boxes, above, apply to you, do not complete this request. You are not an eligible borrower.

2. Did you incur some or all of your Direct Loans or FFEL Program loans before your period of eligible military service?

Yes—The loans that you received prior to your period of eligible military service are loans that are eligible to have their interest rate limited to 6 

percent. Provide a copy of your military orders that show when your period of eligible military service began.

No—You have no eligible loans. Do not complete this request. 

To request that the interest rate on your Direct Loan or FFEL Program loans be limited to 6 percent, you are not required to complete this form. Instead 

of completing this form, you may submit a written request that your interest rate be limited under the SCRA through means such as a letter or email. In 

either case, you must include with your request a copy of your military orders that show when your period of eligible military service began.

SECTION 3: BORROWER REQUEST, UNDERSTANDINGS, AGREEMENT, AUTHORIZATION, AND CERTIFICATION

 I request that my loan holder limit the interest rate on my eligible Direct Loan or FFEL Program loan to 6 percent for my period of eligible military 

service.

 I understand that: 

(1) The SCRA permits me to limit the interest rates on all debts or liabilities that accrue interest at a rate in excess of six percent during my eligible 

military service. This form allows me to request that the interest rate on my federal student loans made under the Direct Loan or FFEL Program 

be limited to 6 percent during my eligible military service. If I am interested in having other debts limited to six percent during my eligible 

military service, I must contact my other loan holders.

(2) To have the interest rate on my eligible Direct Loan or FFEL Program loans reduced under the Servicemembers Civil Relief Act (SCRA), I must 

submit a copy of my military orders that contains information establishing that I am performing eligible military service, including the date that 

my period of eligible military service began.

(3) The interest rate on my eligible Direct Loan or FFEL Program loans will be limited to 6 percent starting on the later of the date that my period of 

eligible military service began or August 14, 2008. My loan holder will make retroactive adjustments to my account, as necessary, if the interest 

rate limitation requires that prior payments be reallocated between fees, interest, or principal or that interest that had previously capitalized be 

recalculated.

(4) I must immediately notify my loan holder if I cease performing eligible military service.

(5) If my military orders do not specify an end date for my period of eligible military service, my loan holder will grant the interest rate limitation for 

a period of one year. To receive an interest rate limitation for more than the initial year, my loan holder may use a database administered by 

the U.S. Department of Defense to determine whether I continue to be performing eligible military service.

 I authorize the loan holder to which I submit this request (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.

 I certify that all of the information I have provided on this form and in any accompanying documentation is true, complete, and correct to the best of 

my knowledge and belief.

Borrower’s Signature Date 

SERVICEMEMBERS CIVIL RELIEF ACT (SCRA): INTEREST RATE LIMITATION REQUEST

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

You may use this form to request that the interest rate on your eligible Direct Loan or FFEL Program loans be limited 

to six percent during your period of eligible military service.

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.

OMB No. 1845-0080

Draft Form

Exp. Date XX/XX/XXXX
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SECTION 4: DEFINITIONS

 Capitalization is the addition of unpaid interest to the principal balance of your loan. The principal balance of a loan increases when payments are 

postponed during periods of deferment or forbearance and unpaid interest is capitalized. As a result, more interest may accrue over the life of the 

loan, the monthly payment amount may be higher, or more payments may be required. The chart below 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 charges will depend on your interest rate, length of the deferment, and frequency of 

capitalization. Paying interest during the period of deferment lowers the monthly payment by about $12 and saves about $426 over the lifetime of the 

loan, as depicted in the chart below.

Treatment of Interest Accrued During 

Deferment

Loan 

Amount

Capitalized Interest 

for 12 Months

Principal to Be 

Repaid

Monthly 

Payment

Number of 

Payments

Total Amount 

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.

 Period of eligible military service means the period of time when a:

o A member of the U.S. Army, Navy, Air Force, Marine Corps, or Coast Guard is on active duty, including full-time duty in the active military 

service of the United States and full-time training duty, annual training duty, and attendance, while in the active military service, at a school 

designated as a service school by law or by the Secretary of the military department concerned, but not including full-time National Guard 

duty;

o A member of the National Guard is performing service on active duty or full-time National Guard duty authorized by the President or the 

Secretary of Defense for a period of more than 30 consecutive days under 32 USC 502(f), for the purposes of responding to a national 

emergency declared by the President and supported by Federal funds; or

o A commissioned officer of the Public Health Service or the National Oceanic and Atmospheric Administration is on active service.

 The William D. Ford Federal Direct Loan (Direct Loan) Program includes Direct Subsidized Loans, Direct Unsubsidized Loans, Direct PLUS Loans, 

and Direct Consolidation Loans. 

 An eligible borrower is a borrower with Direct Loans or FFEL Program loans who received those loans prior to the date that the period of eligible

military service began.

 Eligible Direct Loans and FFEL Program loans are Direct Loan and FFEL Program loans made before the date the period of eligible military service 

began.

 The Federal Family Education Loan (FFEL) Program includes Federal Stafford Loans (both subsidized and unsubsidized), Federal PLUS Loans, 

Federal Consolidation Loans, and Federal Supplemental Loans for Students (SLS). 

 The holder of your Direct Loans is the U.S. Department of Education (the Department). The holder(s) of your FFEL Program loan(s) may be a lender, 

secondary market, guaranty agency, or the Department. Your loan holder(s) may use a servicer to handle billing, payment, repayment options, 

and other communications on your loans. References to “your loan holder” on this form mean either your loan holder(s) or, if your loan holder(s) 

and servicer are different entities, your servicer.

SECTION 5: ELIGIBILITY REQUIREMENTS

 To be eligible to have the interest rate on your Direct Loan or FFEL Program loan limited to 6 percent, you must:

o Have Direct Loan or FFEL Program loans;

o Be performing eligible military service; 

o Have received your Direct Loan or FFEL Program loans prior to the period of eligible military service;

o Request, of your loan holder, that the interest rate on your Direct Loan and FFEL Program loans be limited pursuant to the Servicemember 

Civil Relief Act (SCRA); and

o Provide a copy of your military orders, which contains information that establishes that you are performing eligible military service.

 If you are eligible to have your interest rate limited to 6 percent, the limitation will apply for the duration of your period of eligible military service.

 If you are eligible to have your interest rate limited to 6 percent, the limitation will begin on the later of the date that your period of eligible

military service began or August 14, 2008.

 If your military orders do not provide an end date of your period of eligible military service, your interest rate will be limited to 6 percent for a 

period of one year. To receive an interest rate limitation for more than the initial year, your loan holder may use a database administered by the 

U.S. Department of Defense to determine whether you continue to be performing eligible military service. If the database indicates that you are

no longer performing eligible military service, you loan holder will remove the interest rate limitation from you loans.
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SECTION 6: WHERE TO SEND THE COMPLETED REPAYMENT PLAN REQUEST

Return the a written notice requesting the SCRA interest limitation or the 

completed form and any required documentation to: 

If no address is shown, return to your loan holder(s).

If you need help completing this form, call: 

If no telephone number is shown, call your loan holder(s).

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 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 0.25 hours 

(15 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. Responding to this collection is voluntary for individuals, but this collection may 

be used to obtain a benefit in accordance with 34 CFR 682.202 or 685.202. 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 1845-0080. 

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 holder(s) (see Section 6).