General Forbearance Request Form Page 2

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Borrower Name
Borrower SSN
SECTION 3: BORROWER/ENDORSER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
I understand that:
• I am not required to make payments of loan principal or interest during my forbearance, but interest will continue to
be charged on all my loans.
• My loan holder has sole discretion in whether to grant my general forbearance request and for what dates it will be
granted.
• For Perkins Loans, there is a cumulative limit on general forbearance of 3 years. For Direct Loans and FFEL Program
loans, my loan holder may set a limit on general forbearance.
• My forbearance will end on the earlier of the end date that I requested, 12 months from the date my forbearance
begins, or when I exhaust any limit that my loan holder has on forbearance.
• I can request another forbearance after my forbearance ends if I am still experiencing financial hardship.
• Interest may capitalize on my loans during or at the expiration of my 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, if requested, to support my general forbearance request.
• I will repay my loans according to the terms of my promissory note, even if my request is not granted.
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/Endorser's Signature
SECTION 4: INSTRUCTIONS FOR COMPLETING THE FORBEARANCE REQUEST
Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy) or (mm-yyyy) as appropriate. Example: March 14,
2016 = 03-14-2016. Include your name and account number on any documentation that you may be requested to submit
with this form. If you want to apply for a forbearance on loans that are held by different loan holders, you must submit a
separate forbearance request to each loan holder. Return the completed form and any requested documentation to the
address shown in Section 6.
If you are an endorser, you may request forbearance only when you are required to repay the loan because the borrower is
not making payments. If you have a loan made jointly with another borrower (as co-makers), you must both individually meet
the requirements for a forbearance and each of you must request forbearance.
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