Forbearance Fgreement Form

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Texas Higher Education Coordinating Board
Student Loan Program Operations
1200 East Anderson Lane, Austin, Texas 78752
P.O. Box 12788, Austin, Texas 78711
800/242-3062 512/427-6340 Fax 512/427-6570
FORBEARANCE AGREEMENT
Forbearance is an arrangement to postpone or reduce the amount of a borrower's monthly payment for a limited, specified time period. The
borrower's loan continues to accrue interest during forbearance. Forbearance is available to a borrower who is willing but unable to make scheduled
payments due to a temporary financial hardship. Forbearance requests are subject to lender approval.
Select type(s) of loans:
BOT
CAL
GSL (Stafford)
HEAL / HELP
SLS
TFT
Borrower’s Social Security Number: ________ - ______ - __________
Borrower’s Name: _____________________________________________________
Mailing Address: _______________________________________________________
City: ____________________________________ State: ____
Zip: ___________
Email Address: _________________________________________________________
Home Telephone Number: (_____) _____ - ________
Cell Telephone Number: (_____) _____ - ________
Place of Employment: ___________________________ Work Telephone Number: (_____) _____ - ________
PLEASE COMPLETE ITEMS BELOW
I am willing but unable to make current loan payments due to a temporary financial hardship.
If this forbearance is approved, I choose to: (select one option)
Temporarily stop all payments and request that any past due payments be included in a new
repayment schedule;
Make lower payments than previously scheduled. I am requesting to pay $__________ (not
less than half of the current scheduled monthly installment amount or monthly interest accrual)
Please explain why you feel your circumstances warrant a temporary period of forbearance. Attach
additional sheet(s) if needed.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Complete Monthly Budget
No. of Dependents (exclude self) ____
Family Take Home Pay $__________
Day Care
$__________
Fill in the form using your
Rent/House Payment
$__________
Groceries
$__________
computer to automatically
Auto Payment
$__________
Utilities
$__________
calculate your disposable
Fuel
$__________
Charge Accounts
$__________
income:
Insurance (auto)
$__________
Other Educational Loans $__________
Medical Expenses
$__________
Other (specify)
$__________
Borrower Understanding and Certifications
I understand that: (1) I must pay my current scheduled payment amount until I am notified by my lender that my forbearance
request has been granted; (2) This forbearance 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 whether or not my loan(s) is subsidized by the federal government; (4) If I request a reduced-
payment forbearance, I will receive notification of the required payment amount, and any unpaid interest that accrues during the
period will be added to the outstanding balance of my loan(s); (5) If I receive a reduced-payment forbearance, and I do not make
my schedule payments, my loan may become delinquent, and my lender may perform collection activities; and (6) I will be sent a
new Repayment Schedule and Disclosure Statement at least 30 days before my regular payments will resume.
I certify that: (1) The information I have provided above is true and correct; (2) I will notify my lender immediately when the
condition(s) that qualified me for the forbearance ends; (3) I have read, understand, and meet the terms and conditions of the
forbearance for which I have applied; and (4) I agree, upon termination of this forbearance, to repay this loan according to the
terms of my promissory note and repayment schedule. After you complete the requested information, read, understand,
and agree to the Borrower Understandings and Certifications and the Privacy Act Disclosure Notice on the back of
this form, sign and date the form and mail your completed form to the address above.
_______________________________________________________________________________
_______________________
Borrower Signature
Date

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