Request For Forbearance/hardship/unemployment Deferment Form printable pdf download

Request for Forbearance/Hardship/Unemployment Deferment

I understand that all information and supporting documents given will be held in strictest confidence and will not be subject to dissemination outside the

requirements of Oregon State University. I further understand that this arrangement will consist of reduced or deferred payments, as determined by

Oregon State University based on my financial situation. It may be necessary to make accelerated payments at the expiration of this arrangement to

repay the loan within the maximum ten-year period.

Name

_____________________________________________________

Mail form to:

OREGON STATE UNIVERSITY

STUDENT LOAN OFFICE

Address

_____________________________________________________

P.O. BOX 1086

CORVALLIS OR 97339-1086

_____________________________________________________

Questions:

(541) 737-3778

_____________________________________________________

(541) 737-4099 (fax)

student.loans@oregonstate.edu

Social Security Number _________________________________________

I am requesting temporary deferment or forbearance of the payments on my Federal Perkins Loan. I certify that I am eligible

for deferment/forbearance for the reason(s) listed below:

I am currently unemployed and am actively seeking but unable to find full-time employment. I became unemployed (or began working

less than 30 hours per week) on ____________________________.

You must reapply every six months (3-year limit). Complete other side of this form

(MM-DD-YY)

I am requesting an economic hardship deferment because I have been granted an economic hardship for my William D. Ford Direct

Student Loan, Federal Family Education Loan, or a Perkins Loan from another school.

Documentation from the granting agency is required. You must

reapply every six months (3-year limit).

I am receiving payment under Federal or State Public Assistance such as Temporary Assistance to Needy Families, Supplemental

Security Income, Food Stamps or state general public assistance.

Documentation from the granting agency is required. You must reapply every six months (3-

year limit). Complete other side of this form.

I am working full time (30 or more hours per week) and earning a total monthly gross income that does not exceed the greater of minimum

wage or an amount equal to 100 percent of the poverty line for a family of two, currently set at $1010.00 ($1261.67 in Alaska, $1161.67 in

Hawaii).

You must reapply every six months (3-year limit). Complete other side of this form.

I am working full time (30 or more hours per week) and I am not receiving total monthly gross income that is more than twice the amount

above and that income minus an amount equal to monthly payments on my federal education loans does not exceed the amount specified

above.

You must reapply every six months (3-year limit). Complete lender information below. Complete other side of this form.

I am working full time (30 or more hours per week) and have a federal education debt burden (Perkins, Stafford, Direct, etc.) that is equal

to or greater than 20% of my total monthly income.

You must reapply every six months (3-year limit). Complete lender information below. Complete other side of this

form.

*Listed below is the name of each federal loan lender, the type of loan, amount borrowed and monthly payment.

Attach additional sheet, if needed.

Lender

Type of Loan

Amount Borrowed

Monthly Payment

I am requesting a financial hardship deferment due to extraordinary circumstances (Explain on the back of this form). I am aware that

interest will continue to accrue, and if not paid during the deferment, it will be billed in a lump sum at the end of the deferment and is due

and payable upon receipt.

You must reapply every six months (3-yr limit). Complete other side of this form.

I am requesting a temporary reduction of my monthly loan payments based on my financial situation. I will make monthly payments in

the amount of $________________.

Complete other side of this form.

Section 2 Borrower Certification

I certify that all statements made are true and correct. I also certify that I will immediately notify the lending institution of any change in my

employment status or significant change in my financial situation. I authorize a representative of the lending institution to obtain any

pertinent information in order to verify this application. This account will remain in status quo until this form is approved. If this form is

incomplete, it will be returned for completion.

Signature_______________________________________ Date of Birth________________________ Date____________________

Day Phone________________________ Evening Phone____________________________ Cell Phone_______________________

(over)

Request For Forbearance/hardship/unemployment Deferment Form

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