Graduate Fellowship Deferment Request Form

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GRADUATE FELLOWSHIP DEFERMENT REQUEST
OMB No. 1845-0011
Form Approved
William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family
Exp. Date 9/30/2018
Education Loan (FFEL) Program / Federal Perkins Loan (Perkins Loan) Program
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
GFL
the U.S. Criminal Code and 20 U.S.C. 1097.
SECTION 1: BORROWER INFORMATION
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
Email (Optional)
SECTION 2: BORROWER DETERMINATION OF DEFERMENT ELIGIBILITY
Carefully read the entire form before completing it. Complete Section 2 in its entirety.
1. Do you have a bachelor's degree?
5. Does your graduate fellowship program require you
to submit periodic reports, projects, or other
Yes - Continue to Item 2.
evidence of your progress?
No - You are not eligible for this deferment.
Yes - Continue to Item 6.
No - You are not eligible for this deferment.
2. Have you been accepted or recommended by an
institution of higher education for acceptance into a
graduate fellowship program on a full-time basis?
6. Are you studying at a foreign university?
Yes - Continue to Item 3.
Yes - Continue to Item 7.
No - You are not eligible for this deferment.
No - Complete Section 3 and then have an
authorized official complete Section 4.
3. Does your graduate fellowship program provide
7. Will your graduate fellowship program accept the
sufficient financial support to allow for full-time
course of study from the foreign university towards
study for a period of at least 6 months?
completion of the fellowship program?
Yes - Continue to Item 4.
Yes - Complete Section 3 and then have an
No - You are not eligible for this deferment.
authorized official complete Section 4.
No - You are not eligible for this deferment.
4. Does your graduate fellowship program require,
before the awarding of financial support, a written
statement from you that explains your objectives?
Yes - Continue to Item 5.
No - You are not eligible for this deferment.
SECTION 3: BORROWER REQUESTS, UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
I request:
• To defer repayment of my loans for the period during which I meet the eligibility criteria outlined in Section 2 and as
certified by an authorized official in Section 4.
If indicated, to make interest payments on my loans during my deferment.
•
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