Request For Hardship Deferment Form

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Request for Hardship Deferment
I request an economic hardship or forbearance deferment on my Federal Health Professions or NSLDS/Perkins Loans. I
understand that all information and supporting documents given will be held in strictest confidence and will not be subject
to dissemination outside of the requirements of MUSC. I also understand that if granted, this economic hardship or
forbearance deferment is for no more than 1 year, renewable for a total of three years (each). I understand that interest does
not accrue for an economic hardship but does accrue during the time of forbearance.
Name: ___________________________________ Social Security No._________________
A borrower may defer repayment on a Perkins Loan for up to three years, regardless of disbursement date and contrary
provisions on the promissory note, if the borrower is seeking and unable to find full-time employment.
34 CFR 674.34(d)
Date continuous unemployment began:______________
Check and complete one of the items below as applicable:
A borrower is entitled to an economic hardship deferment for periods of up to one year at a time, not to exceed three years
cumulatively, if the borrower provides the school with satisfactory documentation showing that he or she is within any of
the following categories:
1.
has been granted an economic hardship deferment for either a Stafford or PLUS loan for the same period of time for
which the Perkins Loan deferment has been requested;
2.
is receiving federal or state public assistance, such as Temporary Assistance to Needy Families (TANF) (formerly, Aid
to Families with Dependent Children (AFDC))Supplemental Security Income, Food Stamps, or state general public
assistance;
3. is working full time and is earning a total monthly gross income that does not exceed $937.50, ($1171.67 for
Alaska, $1077.50 for Hawaii).
4.
is not receiving total monthly gross income that is more than twice the amount in (3) above and that income minus an
amount equal to the borrower’s monthly payments on federal postsecondary education loans does not exceed the
amount specified in (3) above;
5.
is working full time and has a federal educational debt burden that is 20 percent or more of the borrower’s total monthly
gross income and the borrower’s total monthly gross income minus such burden is less than 220 percent of the greater
of (3) above; or
6.
is serving as a volunteer in the Peace Corps.
34 CFR 674.34(e)
Complete the worksheet on the reverse side of this form to determine eligibility for hardship deferment. Also, you may use
the reverse of this form in conveying any circumstances that you feel would have a bearing on your request.
I certify that all statements made above are true and correct. I also certify that I will immediately notify your office of any
change in my employment status or significant change in my financial picture.
Signature_______________________________________________ Date: _____________
Determine the total amount you borrowed in federal education loans that are now in repayment by adding together the
amounts owed for the federal education loans listed below. You may include defaulted loans only if you have made
satisfactory repayment arrangements with the holder of the loans.
Loan Type
Total Amount You Owed When Your Loans Entered Repayment
Federal Stafford Loans (subsidized and unsubsidized)
$ _______________________________________
Direct Subsidized and Direct Unsubsidized Loans
+ $_______________________________________
Federal or Direct PLUS Loans
+ $_______________________________________
Federal SLS Loans
+ $_______________________________________
Federal or Direct Consolidation Loans
+ $_______________________________________

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