Mds For New Mexico Physician Working Outside The State Of New Mexico - Request For Reduction Of Outstanding Principal Balance By 4.5% After Receiving 33 On-Time Monthly Payments
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2MDs for New Mexico Physician Working outside the State of New Mexico
Request for reduction of outstanding principal balance by 4.5% after receiving 33 on-time monthly Payments
Name _______________________________________________________
Social Security Number _________________________________________
Street Address__________________________________________________________________________
City________________________________State______________________Zip______________________
Home Phone ______________________Work Phone ______________________Date of Birth__________
E-mail Address_____________________________________________________
Date graduated from UNM Medical School___________________________________________________
I certify that I am now and have been working full time as a practicing Medical Doctor from ____________ to_____________
mm/dd/yy
mm/dd/yy
at____________________________________________________________________________________
Name of Employer
______________________________________________________________________________________
Street Address
______________________________________________________________________________________
City and State Address
I certify I have read and understand the conditions for eligibility on the reverse side of this request and will
meet all the qualifications for the 4.5% principal reduction after 33 on-time monthly payments. I
understand that I must submit my request and certification yearly. I understand that New Mexico Student
Loans reserves the right to terminate this benefit program at any time.
________________________________________ ___________________________________________
Borrower’s Signature
Today’s Date
Return form to:
New Mexico Student Loans (NMSL) – P.O. BOX 27020, Albuquerque, NM 87125-7020
Phone: 1-800-279-5063, ext. 1472 – Fax: 505-345-7269 – E-mail:
Revised 12/2013
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