Income Sensitive Repayment Schedule Request Form

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INCOME SENSITIVE
Correspondence:
PO Box 5209
Helena MT 59604-5209
Payments:
PO Box 1689
REPAYMENT
Helena MT 59624-1689
Phone:
(800) 852-2761
Fax:
(406) 495-7880
SCHEDULE REQUEST
Website:
SECTION 1: BORROWER/ENDORSER IDENTIFICATION
Name: ________________________________________
Account Number: ______________________________
Address: ______________________________________
Telephone-Home: _____________________________
______________________________________
Telephone-Other: _____________________________
City, State, Zip Code: ____________________________
Email Address (Optional): _______________________
SECTION 2: INCOME SENSITIVE PAYMENT AMOUNT
Your Total Monthly Gross Income from all sources:
$
**Include proof of your monthly gross income with this request.
$
Requested Monthly Payment Amount:
Student Assistance Foundation (SAF) will make every effort to comply with your request for a specific payment
amount. However, federal regulations require your monthly payment to equal at least the amount of interest which
accrues on your loan(s) each month. Also, if your account is in a paid-ahead status, you authorize Student Assistance
Foundation to remove the paid-ahead status to apply the requested Income Sensitive Repayment Schedule.
Additionally, you must submit proof of income for Student Assistance Foundation to process your request. If you
have questions about how to complete this form, contact Customer Service at (800) 852-2761, or e-mail
.
SECTION 3: FORBEARANCE AGREEMENT
If my loan(s) is past due and I do not send the past due amount, I request my account be brought to a current status
prior to my being granted an Income Sensitive Repayment schedule. This would involve adding any outstanding
accrued interest to the principal balance of my loan(s). If I am ineligible for an Income Sensitive Repayment schedule,
I may be granted a forbearance to bring my account to a current status. If I am in a deferment or forbearance status
at the time I request the Income Sensitive Repayment schedule, I authorize SAF to end the deferment or forbearance
early in order to process my new repayment plan request. If SAF grants a forbearance or ends the current deferment
or forbearance, any outstanding interest will be added to the principal balance at that time (capitalized). I agree to
repay this loan according to the terms of my Promissory Note and Income Sensitive Repayment Schedule.
SECTION 4: BORROWER/ENDORSER UNDERSTANDINGS AND CERTIFICATIONS
I authorize the school, the lender, the guarantor, the Department, and their respective agents and contractors to
contact me regarding my loan(s), including repayment of my loan(s), at the current 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.
I certify that the financial information reported above is a true representation of my current income and I have
enclosed evidence supporting my current monthly gross income. I further certify that, based upon my current income
level, I would be unable to repay my loan(s) within the timeframe required by federal regulations.
Borrower Signature __________________________________________________ Date __________________
Return the completed form and any required documentation to:
Mail:
Student Assistance Foundation
Email:
PO Box 5209
Helena MT 59604-5209
Fax:
(406) 495 - 7880

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