Forbearance/economic Hardship/unemployment Deferment Request For Federal Perkins/ndsl Loans

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UNIVERSITY OF COLORADO

FORBEARANCE/ECONOMIC HARDSHIP/UNEMPLOYMENT DEFERMENT REQUEST

FOR FEDERAL PERKINS/NDSL LOANS

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form shall be subject to penalties which may

include fines, imprisonment or both, under the U.S. Criminal Code U.S.C 1097

BORROWER INFORMATION

First Name

Last Name

Social Security Number

Student Number (if different than SSN)

(

)

Street Address

Phone

Cell

(

)

City, State, Zip

Phone

Alternate

(

)

Phone

FORBEARANCE, ECONOMIC HARDSHIP, UNEMPLOYMENT DEFERMENT REQUEST

Forbearance is an arrangement to postpone or reduce the amount of a borrower's monthly payment for a limited and specific time period. The borrower is

charged interest during forbearance. Economic hardship and unemployment deferments postpone monthly payments for a limited and specific amount of time

without interest accrual. A student loan representative will work with you to decide what you qualify for depending on the situation and documentation provided.

To request a forbearance, economic hardship or unemployment deferment, please complete the items below, sign and date this form and return it to :

University of Colorado, Regent 150, 47 UCB, Boulder, CO 80309-0047

I am willing but not able to make my current Federal Perkins/NDSL Loan payments due to a temporary financial hardship.

If a forbearance/economic hardship is approved, I choose to (check one):

temporarily stop making payments;

per month.

make smaller payments than previously scheduled. I would like to pay

I am requesting this forbearance, economic hardship or unemployment deferment because:

I am requesting that the University of Colorado grant a forbearance, economic hardship or unemployment deferment for a period not to

exceed one year, beginning

(MM-YY), and ending

(MM-YY), I may reapply if I am still experiencing

financial hardship at the end of the deferment period.

IMPORTANT: THE FOLLOWING DOCUMENTATION MUST BE PROVIDED AND ATTACHED TO THIS FORM

For UNEMPLOYMENT

Letter from an employment agency or from state unemployment service; copy of my most recent unemployment check;

letter of last date of employment. Evidence that other educational loans are in unemployment deferment status.

Copy of most recent pay stub; copy of most recent W2 or tax return; evidence of amounts received from government

For FORBEARANCE OR

sources, such as Food Stamps, WIC, Social Security checks, unemployment checks, etc.

ECONOMIC HARDSHIP:

Evidence that your total monthly payment amount for all educational loans is equal to or greater than 20% of gross

monthly income.

Evidence that other educational loans are in economic hardship deferment status.

Any other documentation requested by the University of Colorado to certify the condition described above, or which

you feel will clarify the reason for the inability to pay.

BORROWER UNDERSTANDINGS AND CERTIFICATIONS

I understand that: (1) I will continue to receive billing statements for my current payment amount which I must pay until I am notified by the University of Colorado that my hardship

request has been granted; (2) this hardship request will not be granted unless all items on this form are completed and any additional required documentation is provided; (3) during the

forbearance period, principal and interest payments may be forborne, but interest will continue to accrue; (4) if I requested a temporary suspension of payments, I will receive a statement

at the end of the forbearance for any unpaid interest that has accrued, and that interest shall be due and payable on the date the forbearance ends; (5) if I requested a reduced payment

amount until the forbearance ends, I will receive a monthly bill for the requested payment amount until the forbearance ends, and any unpaid interest that has accrued during the period

will be due and payable on the date the forbearance ends.

I certify that: (1) The information I have provided above is true and correct; (2) I will provide additional documentation, as required, to the University of Colorado to support my

continued forbearance, economic hardship or unemployment status; (3) I will notify the University of Colorado immediately when the condition(s) that qualified me for the forbearance,

economic hardship or unemployment ends; (4) I have read, understand, and met the terms and conditions of the forbearance, economic hardship or unemployment deferment for which I

have applied; and (5) I agree, upon termination of this forbearance, economic hardship or unemployment deferment, to repay this loan according to the terms of my promissory note

and repayment schedule.

Signature of Borrower

Date

Rev 1.1 7/25/07

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