Nm Student Loans Teachers For Tomorrow - Request For Interest Benefit Form
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2NM Student Loans
Teachers for Tomorrow
Request for Interest Benefit
Name________________________________________ Social Security Number _____________________________________
Street Address__________________________________________________________________________________________
City ______________________________________________________ State ______________________ Zip______________
Home Phone_________________Work Phone_________________ Date of Birth ___________________________________
Last School Attended ___________________________________________________________________________________
Graduation Date ______________________________________ Email ____________________________________________
I certify that I am or was employed from ________________________ to___________________
mm/dd/yy
mm/dd/yy
and meet the eligibility requirement for the Teachers for Tomorrow program as listed on the reverse side of this form.
School Name_______________________________________District/County_________________________
I certify I have read the conditions for eligibility on the reverse side of this request and meet all qualifications for the interest
benefit on my loan(s). I understand that I must submit my request and certification at the beginning of every academic year, as
long as I am eligible, in order to receive the interest benefit. I understand that I am required to notify NM Student Loans of any
changes to my eligibility status.
________________________________________________________________
_____________________________
Borrower’s Signature
Date
MUST BE COMPLETED BY CERTIFYING OFFICIAL
(Principal, Assistant Principal, District Office, Human Resource Officer or Program Director of Head Start)
I certify the information above is correct.
______________________________________________
_________________________
______________
Signature of Authorizing Official
Title of Authorizing Official
Date
______________________________________________
Employment Dates of Applicant
Printed Name of Authorizing Official
____________________/_____________________
______________________________________________
From: mm/dd/yy
To: mm/dd/yy
Address of School
_________________________________________
______________________________________________
Job Title
Hours per Week
City/State/Zip
______________________________________________
Phone
New Mexico Student Loans
Return Form To:
PO Box 27020
Albuquerque, NM 87125-7020
NMEAF DBA NM Student Loans
1-800-279-5063, ext. 1472
Fax: 505-345-7269
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