Economic Hardship Deferment Request Page 2

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SECTION D. Borrower Understanding and Certification:
(1) My deferment will begin no more than six months before the date the University of Minnesota
I understand that:
receives this request; (2) the University of Minnesota will not grant this deferment unless all applicable sections of this
form are completed and required documentation is provided; (3) principal and interest payments will be deferred for the
approved deferment period.
(1) The information provided above is true and correct; (2) I will provide additional documentation as re-
I certify that:
quired to support my continued deferment status; (3) I will notify the University of Minnesota immediately when the
condition(s) that qualified me for the deferment end; and (4) I have read, understand, and meet the terms and conditions
of the deferment for which I have applied.
_____________________________________________
______________
Borrower Signature
Date
office use only
Definitions
Total Monthly Gross Income is the gross amount of income received by the borrower from employment
and from other services (sources).
Lender information
Approved
from _____________________ to ___________________
Beginning Date
Ending Date
Disapproved
University Representative
_____________________________________________________
Date _____________
Signed
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