Page **1** of **4** 

## Federal Direct Consolidation Loan Verification Certificate **William D. Ford Federal Direct Loan Program [**  **60 -**  **DAY CLEARANCE DRAFT 1**  **2 /**  **1 9** **/2013]** OMB No. 1845
- 0053 Form Approved Exp. Date xx/xx/xxxx

The borrower identified in Item 3 of this Loan Verification Certificate (LVC) has requested consolidation of his or her eligible education loan(s) and has identified you as a holder of one or more of those loan(s). The Federal Direct Consolidation Loan Program (Direct Consolidation Loan Program) enables borrowers to apply for a Direct Consolidation Loan to consolidate outstanding education loans pursuant to Title IV of the Higher Education Act of 1965, as amended. Loans that may be consolidated are listed in the instructions on the back of this LVC. This LVC is u sed to verify t he eligibility and payoff amount of the borrower’s outstanding education loan(s). As part of the Federal Direct Consolidation Loan Application and Promissory Note, the borrower named in Item 3 has authorized yo ur disclosure of information regarding all of the borrower’s federal education loan(s) that you hold. List each loan that you hold in Item 6 on page 2 of this LVC, and for each loan provide the information requested in Items 7 through 17. **Please Print**
. **Pursuant to 34 CFR 685.220(f)(1)(i), you must com plete and return this LVC within 10 business days of the date received.**  Return the completed LVC to the following address:

[INSERT SERVICER INFORMATION HERE]

**See the instructions on page 3 of this LVC**  **.** If you have questions or need help completing this LVC, please call **[INSERT SERVICER CONTACT INFORMATION]. (1)**  **Holder/Servicer Information** Holder/Servicer is (check only one): 

##  Lender 

##  Servicer for Lender 

##  Guaranty Agency 

##  Servicer for Guaranty Agency 

##  School 

##  Servicer for School Name ____________________________________________ OPE Code _________________________________________ Street 1 ___________________________________________ Street 2

___________________________________________ City, State, Zip Code _________________________________ Area Code/Telephone # ( ______ ) ______

-

________ Area Code/Fax # ( ______ ) ______

-

________ **(2) Institution or address**  **to which payoff should be sent** (if different from Item 1) Name ____________________________________________ OPE Code _________________________________________ Street 1 ___________________________________________ Street 2

___________________________________________ City, State, Zip Code _________________________________ Area Code/Telephone # ( ______ ) ______

-

________ Area Code/Fax # ( ______ ) ______

-

________ Contact’s Name _____________________________________ **(3) Borrower Information**
Name ____________________________________________ Social Security Number ___ ___ ___ - ___ ___ - ___ ___ ___ ___ Street 1 ___________________________________________ Street 2 ___________________________________________ City, State, Zip Code _________________________________ Area Code/Telephone # ( ______ ) ______

-

________

**(4 )**  **Holder/Servicer Certification:** I certify that:  To the best of my knowledge and belief, the information on this LVC is accurate and complete;
 E ach loan identified in Item 6 on page 2 of this LVC **(a)** is a legal, valid, and binding obligation of the borrower; **(b)** was made and serviced in compliance with all applicable laws and regulations; and **(c)** i n the case of Federal Stafford Loans [subsidized and unsubsidized (GSL)], Federal PLUS Loans, Federal Supplemental Loans for Students (SLS) [and Au xiliary Loans to Assist Students (ALAS)], and Federal Insured Student Loans (FISL), the insurance on each loan is in full force an d effect.
 The loan amount listed i n Item 1 8 on page 2 of this LVC is the amount necessary to discharge the loan(s). This LVC will be relied on by the U.S. Department of Education in paying off the listed loan(s). **Signature of Authorized Official** ___________________________________ **Holder/ Servicer Name** 

_______________________________ __________________ **Date (mm -** **dd -** **yyyy)** ___ ___ - ___ ___ - ___ ___ ___ ___ **Name/ Title of Authorized Official (please print)**  ____________________________________________________________ **Area Code/Telephone #** ( ______ ) ______

-

________Page **2** of **4** 

## Federal Direct Consolidation Loan Verification Certificate **(continued) Holder/Servicer Name**  ____________________________________________________________________ **Borrower Name**

_____________________________________________ __ **OPE Code** _________________________ **Borrower Social Security Number** ___ ___ ___ - ___ ___ - ___ ___ ___ ___ **(5)** Certification Date (mm

- dd

-yyyy) ___ ___ - ___ ___ - ___ ___ ___ ___ # **(6)** Account Number **(7 )** 

Loan Type **(8 )** 

Interest Rate (%) **(9 )** 

Principal Balance Outstanding **(10 )** 

Unpaid Accrued Interest through Certification Date (Item 5 ) **(11 )** 

Fees and Late Charges **(12 )** 

Collection Costs **(13 )** 

Total Amount Due Through Certification Date (Item 5) **(14)**

First/Only Disbursement Date (mm

- dd

-yyyy) **(15)**

Separation Date **(16)**

Loan Status Code **(17)**

IBR Information **(a)** IBR Start Date **(b)** Days of Economic Hardship Deferment
**#1 (a)**  **(b) #2**  **(a) (b)**  **#3 (a)**  **(b) #4**  **(a) (b)**  **#5 (a)**  **(b) #6**  **(a) (b)**  **#7 (a)**  **(b) #8**  **(a) (b)**  **#9 (a)**  **(b) #**  **10 (a)**  **(b) (1**  **8 )**  Total Payoff Amount
**(19)** Comments

_____________________________________________________________________________________________________________________________ __________________________________________Page **3** of **4** 

## Instructions for Completing **Federal Direct Consolidation Loan Veri fication Certificate** 
The borrower named in this Loan Verification Certificate ( LVC ) has requested a Direct Consolidation Loan to repay one or more eligible federal education loan s . The borrower has identified one or more loan s you hold as loans to be consolidated . As part of the application process for a Direct Consolidation Loan, each loan holder/servicer identified by the borrower must complete this LVC . After receiving the LVC from you and determining that the loans are eligible for consolidation, t he U.S. Department of Education (ED) will pay off the borrower's debt to you using the information you provide on this LVC or, if you do not return this LVC by the specified deadline, by using information from ED’s National St udent Loan Data System (NSLDS)
. Before paying off the borrower’s loans, ED will send the borrower a notice that provides information about all of the loans and payoff amounts that have been verified, and informs the borrower of the deadline for notifying ED that he or she wants to cancel the Direct Consolidation Loan, or does not want to consolidate one or more of the loans listed in the notice. Upon receipt of paymen t from ED, you must notify the borrower that the loan s that were with you have been paid in full. An overpayment from ED or any payments you receive fro m the borrower after you receive ED's payment must be sent to ED for application to the borrower's Direct Consolidation Loan. If the borrower contacts you about his or her account while the Direct Consolidation Loan applicat ion is in process, you should tell the borrower to continue to make regularly scheduled payments on the loan to avoid default. **Pursuant to 34 CFR 685.220 (f)(1)(i), this certificate must be completed and returned within 10 business days of the date receive** **d to the address provided on**  **page 1 of this LVC .**  **Holder/Servicer Instructions:** Some of the information may be preprinted. Enter dates as month

- day

year (mm

- dd

-yyyy). Us e only numbers. Example: June 1, 2014 = 06
-01
- 2014
. **Item 1:** Enter or correct the holder/servicer information. **Item 2:** If the payoff check should be sent to a different institution and/or address than that in Item 1, enter the requested information. **Item 3:** Enter or correct the borrower’s full name, Social Security Number, current addre ss, and current area code/telephone number. **Item 4:** Sign, date, and provide the other requested information. **Item 5:** Enter the date you complete this certificate. **Note:** If you are no longer the holder/servicer of one or more of the loans listed, complete the information for the loans you hold and indicate in Item 1 9 the new holder/servicer for the other loans, if known. **Item 6**  **:** Enter the account number assigned to each loan for which you are the holder/servicer. If you have multiple accounts for this borrower, list them as #1, #2, etc. If the account number is the same for each loan, enter “same” on the subsequent lines. **Item 7**  **:** Enter the loan type, using the codes shown in the chart on page 4
. **Note:** Loan type **W** should be used for other types of education loans that may not be consolidated, but that can be included as part of the borrower’s total in debtedness when assigning a repaymen t term. Explain in Item 19 the reason you believe a loan may not be eligible for consolidation
. **Item 8**  **:** Enter the annual interest rate (percent) in effect for the loan as of the certification date
. **Item 9** **- 1**  **2 :**  Provide the payoff amount for each loan, which is the sum of the following, as of the certification date in Item 5 : **Item 9**  **:** Principal outstanding (including capitalized interest) **Item 10**  **:** Unpaid accrued interest through certification date **Item 1 1**  **:** Unpaid fees and late charges, if applicable (as authorized by ED’s regulations) **Item 1 2**  **:** Unpaid collection costs, if applicable (as authorized by ED’s regulations) **Item 1 3**  **:** Enter the total amount of Items 9 through 1 2
. **Item 14:** Enter the first, or only, disbursement date for the loan. **Item 15:** If the loan is in the grace period, enter the date the borrower completed his or her program, graduated, or ceased half

-time enrollment. **Item 16:** Enter the current status of the borrower’s accounts using the status codes from the list on page 4
. **Item 17:** Complete Items 17a and 17b only if: **(i)** the loan you hold is loan type A, D, E, or O (see instructions for Item 7 ); and **(ii)** the borrower has repaid or is currently repaying that loan under the I ncome - B ased R epayment (IBR) Plan. Otherwise, leave Items 17a and 17b blank. If **(i)** and **(ii)** apply, for each lo an that has been or is currently in repayment under the IBR Plan : **17a:** Enter the date the borrower’s IBR Plan started. **17b:** Enter the number of days of economic hardship deferment the borrower has received since the IBR Plan
. **Item 1 8**  **:** Enter the total payoff amount due to the holder/servicer shown on this certificate. **Item 1 9**  **:** Enter any appropriate comments. If unable to complete this certificate, please provide an explanation here. **Note:** When the consolidation process is complete, we will send the hold er, servicer, or institution listed in Item 1 or 2 a payment for the sum of principal, interest, and allowable collection costs and fees. We will send a guaranty agency the payment for allowable collection costs and fees. However, the guaranty agency’s principal and interest balances will be accounted for by Treasury form SF 1081.Page **4** of **4**

**Loan Status Codes Code**  **Loan Status AV**  Submitted for Default Aversion **BA** Bankruptcy **DE** Deferment **DI** Currently Subject to Judgment or Wage Garnishment Order **DN** Default
– Satisfactory Repayment Arrangements Not Made **DS** Default
– Satisfactory Repayment Arrangements Made **FB** Forbearance **GR** Grace **IS** In School **ND** Not Fully Disbursed **OT** Other (explain in Item 19) **PF** Paid in Full **RP** Repayment **TD** Technical Default

-- More Than 270 Days Delinquent **TR** Transferred to Another Servicer **Loan Type Codes Code**  **Loan Type A**  Subsidized Federal Stafford Loans **B** Guaranteed Student Loans (GSL) **C** Federal Insured Student Loans (FISL) **D** Direct Subsidized Loans **E** Direct Subsidized Consolidation Loans **F** Federal Perkins Loans **G** Unsubsidized (including Nonsubsidized) Federal Stafford Loans (including Nonsubsidized Stafford Loans) **H** Federal Supplemental Loans for Students (SLS) **I** Direct PLUS Loans for Graduate/Professional Students **J** Unsubsidized Federal Consolidation Loans **K** Direct Unsubsidized Consolidation Loans **L** Direct Unsubsidized Loans **M** National Direct Student Loans (NDSL) **N** National Defense Student Loans (NDSL) **O** Subsidized Federal Consolidation Loans **P** Auxiliary Loans to Assist Students (ALAS) **Q** Health Professions Student Loans (HPSL) **R** Health Education Assistance Loans (HEAL) **S** Federal PLUS Loans for Graduate/Professional Students **T** Federal PLUS Loans for Parents **U** Direct PLUS Loans for Parents **V** Direct PLUS Consolidation Loans **Y** Nursing Student Loans (NSL) **Z** Loans for Disadvantaged Students (LDS) **W** Education loans ineligible for consolidation **Paperwork Reduction Notice:** According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless the collection displays a valid OMB control number. Public reporting burden for this collection of infor mation is estimated to average 0.15 hours (9 minutes) per response, including time for reviewing instructi ons, 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 mandatory in accordance with 34 CFR 685.220(f)(1)(i). Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Education, 400 Maryland Ave., SW, Washington, DC 20210
-4537 or email ICDocketMgr@ed.gov and reference OMB Control Number 1845

- 0053. **Do not return the completed LVC to this address.**