Graduate Fellowship Deferment Request Form (Page 2 of 4) in pdf

Borrower Name

Borrower SSN

SECTION 3: BORROWER REQUESTS, UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION (CONTINUED)

I understand that:

• I am not required to make payments of loan principal or interest during my deferment.

• My deferment will begin on the date I became eligible, as certified by the authorized official.

• My deferment will end on the earlier of the certified deferment end date or when I am no longer eligible for the

deferment for another reason.

• If I am a Perkins Loan borrower, I will receive a 6-month post-deferment grace period beginning on the date I no

longer qualify for the deferment.

• Interest may capitalize on my loans during or at the expiration of my deferment or forbearance, but interest never

capitalizes on Perkins Loans.

I certify that:

• The information I have provided on this form is true and correct.

• I will provide additional documentation to my loan holder, as required, to support my deferment eligibility.

• I will notify my loan holder immediately when my eligibility for the deferment ends.

• I have read, understand, and meet the eligibility requirements in Section 2.

I authorize the entity to which I submit this request and its agents to contact me regarding my request or my loans at any

cellular telephone number that I provide now or in the future using automated telephone dialing equipment or artificial or

prerecorded voice or text messages.

Date

Borrower's Signature

SECTION 4: AUTHORIZED OFFICIAL'S CERTIFICATION

Do not complete this section unless the borrower has completed Section 2 in its entirety. Note: Instead of having an

authorized official complete this section, you may attach separate documentation from an authorized official that includes all

of the information requested below and a certification that you and the program meet all conditions indicated by your

responses in Section 2.

• The program begins/began on:

• The program is expected to end/ended on:

I certify, to the best of my knowledge and belief:

• The borrower and the program meet all conditions indicated by the borrower's responses in Section 2; and

• The information that I have provided in this section is accurate.

Name of Institution

OPEID (if applicable)

Address

City

State

Zip Code

Official's Name/Title

Telephone

Date

Official's Signature

SECTION 5: INSTRUCTIONS FOR COMPLETING THE DEFERMENT REQUEST

Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Example: March 14, 2015 = 03-14-2015. Include

your name and account number on any documentation that you are required to submit with this form. 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. Return the completed form and any required documentation to the address shown in Section 7.

Page 2 of 4

Graduate Fellowship Deferment Request Form Page 2

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