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 HRD

ECONOMIC HARDSHIP 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

Read Section 7 before completing Section 2.

1. Have you been granted an Economic Hardship 

Deferment on another federal student loan for the 

same period of time for which you are applying for 

this deferment?

A federal student loan includes a loan made under the 

Direct Loan Program, the FFEL Program, or the Perkins 

Loan Program.

Yes – Attach documentation of the deferment.

Skip to Section 3.

No – Continue to Item 2.

2. Have you received payments under a Federal or State 

public assistance program that supports the period of 

time for which you are applying for this deferment? 

Qualifying programs include: Temporary Assistance for 

Needy Families (TANF), Supplemental Security Income 

(SSI), Supplemental Nutritional Assistance Program 

(SNAP), State general public assistance, or other 

means-tested benefits.

Yes – Attach documentation of the payments. Skip 

to Section 3.

No – Continue to Item 3.

3. Are you serving as Peace Corps volunteer?

Yes – Attach documentation certifying your period 

of service in the Peace Corps. Skip to Section 3.

No – Continue to Item 4.

4. Do you work full time (see Section 5)?

Yes – Continue to Item 5.

No – You do not qualify for this deferment. 

Consider an income-driven repayment plan, 

unemployment deferment, or forbearance.

5. What is your monthly income? $ _______________

You must attach documentation of your monthly 

income. Monthly income is either (you choose):

 Your gross income from all sources; or

 One-twelfth of the Adjusted Gross Income from 

your most recent federal income tax return.

6. What is your family size (see Section 5)? ___ ___

7. Is the amount you reported in Item 5 less than 150% 

of the poverty guideline for your family size and state 

of residence (see Table 1)?

Yes –Continue to Item 8.

No – You do not qualify for this deferment. 

Consider an income-driven repayment plan or 

forbearance.

Table 1. 150% of the Poverty Guidelines for 2015 (Monthly)

Family Size Alaska Hawaii All Others

1 $1,840.00 $1,693.75 $1,471.25

2 $2,490.00 $2,291.25 $1,991.25

3 $3,125.00 $2,888.75 $2,511.25

Each add’l 

person, add $635.00 $597.50 $520.00
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Borrower Name: ______________________________ Borrower SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 2: DEFERMENT REQUEST (CONTINUED)

8. When do you want your deferment to begin?

___ ___ - ___ ___ - ___ ___ ___ ___

Continue to Item 9.

9. 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 to Section 3.

No – Continue to Section 3.

SECTION 3: BORROWER REQUEST, UNDERSTANDINGS CERTIFICATIONS, AND AUTHORIZATION

I request to defer repayment of my loans for the period during which I have an economic hardship, as described 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 later of the date the deferment condition began or the date that I identify in 

Item 8

3. My deferment will end on the earlier of the date that the condition that establishes by deferment eligibility ends 

or the certified deferment end date.

4. My maximum cumulative eligibility for an Economic Hardship Deferment on my Direct Loan is 36 months. My 

maximum cumulative eligibility for an Economic Hardship Deferment on my FFEL Program loans is 36 months. 

5. Unless I am a Peace Corps volunteer, my deferment will be granted in increments of 1 year. If I continue to be 

eligible for an Economic Hardship Deferment after 1 year, I may reapply, subject to the cumulative maximum.

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: ___ ___ - ___ ___ - ___ ___ ___ ___
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SECTION 4: 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.

SECTION 5: 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 2) 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).

Family size includes you, your spouse, your 

children if they receive more than half of their support 

from you, including unborn children who will be born 

during the deferment period, and other people if, at the 

time you request this deferment, they live with you, 

receive more than half their support from you, and will 

continue to receive this support from you for the 

deferment period. Support includes money, gifts, loans, 

housing, food, clothes, car, medical and dental care, and 

payment of college costs.

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 Loans)

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 means 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 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.
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SECTION 5: DEFINITIONS (CONTINUED)

Table 2. 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.

SECTION 6: ELIGIBILITY REQUIREMENTS

You are eligible for this deferment if you answer “yes” in Items 1, 2, or 3, or answer “yes” to Items 4 and 7.

For Direct Loan borrowers only, you are eligible for this deferment if you meet the criteria above, regardless of 

when you borrowed your Direct Loans. 

For FFEL Program borrowers only, you are only eligible for this deferment if all of your FFEL Program loans were 

first disbursed on or after July 1, 1993, or if you had no balance on a FFEL Program loan that was disbursed before July 1, 

1993 when you received a loan on or after July 1, 1993.

SECTION 7: WHERE TO SEND THE COMPLETED FORM

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

SECTION 8: 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 
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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 7).