Unemployment Deferment Request - Osla

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UNEMPLOYMENT DEFERMENT REQUEST
OMB No. 1845-0011
Form Approved
Exp. Date 7/31/2015
William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family Education Loan (FFEL) Program
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying document is subject to
UNEM
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 Code
Telephone – Primary
Telephone – Alternate
E-mail Address (optional)
SECTION 2: DEFERMENT REQUEST
Before completing this form, carefully read the entire form, including the instructions and other information in Sections 4, 5, and 6.
 I meet the eligibility requirements stated in Section 6 for an Unemployment Deferment and request that my loan holder defer repayment of my loan(s). To document eligibility,
complete the following:
(1) I became unemployed or began working less than full time (as defined in Section 5) on
. Except as explained in Section 3, my deferment begins on
this date unless I request my deferment to begin on the following later date:
.
(2) Check ONE of the boxes below:
(A)
I am diligently seeking but unable to find full-time employment in the United States (as defined in Section 5) in any field or at any salary or responsibility level. I am
registered with a public or private employment agency if there is one within 50 miles of my current address. Further, if I am requesting an extension of an existing
Unemployment Deferment, I have made at least six diligent attempts to find full-time employment in the most recent 6 months.
NOTE: School placement offices and “temporary employment” agencies do not qualify as public or private employment agencies.
OR
(B)
I am eligible for unemployment benefits, and I have attached documentation of my eligibility for these benefits. The documentation includes my name, address, and
social security number, and shows that I am eligible to receive unemployment benefits during the period for which I am requesting deferment.
SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
 I understand that:
(1) I am not required to make payments of loan principal during my deferment. Interest will not accrue on my subsidized loan(s) during my deferment. However, interest will accrue
on my unsubsidized loan(s).
(2) I may pay the interest that accrues on my unsubsidized loan(s) during my deferment. I may choose to make interest payments by checking the box below. My loan holder may
capitalize interest that I do not pay during the deferment period on my unsubsidized loan(s). I wish to make interest payments on my unsubsidized loan(s) during my deferment.
I wish to make interest payments on my unsubsidized loan(s) during my deferment.
(3) My deferment will begin on the date I became unemployed or began working less than full time, as shown in Section 2, unless I request my deferment to begin on a later date.
However, if this is my first Unemployment Deferment request for my current period of unemployment and I am not providing documentation of my eligibility for unemployment
benefits, my deferment will begin no more than 6 months before the date my loan holder receives this request, even if I became unemployed or began working less than full time
more than 6 months ago.
(4) My deferment will end on the earlier of the date I obtain full-time employment or the date on which I exhaust my maximum cumulative eligibility. My deferment will last for no
more than 6 months after the date my loan holder receives the deferment request.
(5) My maximum cumulative eligibility is:
• For Direct Loan Program borrowers: 36 months.
• For FFEL Program borrowers: (a) 36 months if I did not have an outstanding balance on a FFEL Program loan that was first disbursed before July 1, 1993 when I obtained
a FFEL Program loan on or after July 1, 1993; or (b) 24 months if my first loan(s) were first disbursed before July 1, 1993.
(6) If my deferment does not cover all my past due payments, my loan holder may grant a forbearance on my loan(s) for all payments due before the begin date of my deferment. If
the period for which I am eligible for a deferment has ended, my loan holder may grant a forbearance on my loan(s) for all payments due when my deferment request is
processed. Interest that accrues during this forbearance may be capitalized.
(7) My loan holder may grant a forbearance on my loan(s) for up to 60 days, if necessary, 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 the condition that qualified me for the deferment ends. (4) I have read, understand, and meet the eligibility
requirements of the deferment for which I have applied, as explained in Section 6.
 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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