Income-Driven Repayment Plan Request Form - U.s. Department Of Education Page 3
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10SECTION 6: BORROWER REQUEST UNDERSTANDINGS, AUTHORIZATION, AND CERTIFICATION
I request to use the plan I selected in Section 2 to repay my eligible Direct Loan or FFEL Program loans held by the
holder to which I submit this form. If I selected the option to allow my loan holder to choose my plan or I do not
qualify for the plan(s) I requested, I request my loan holder place me in the plan with the lowest monthly payment
amount. If I selected more than one plan, I request my loan holder place me in the plans with the lowest monthly
payment amount from the plans that I requested. If more than one plan provides the same initial payment amount, I
understand that my loan holder will choose the plan that is likely to keep my monthly payment amount lower in
subsequent years or provides terms and conditions that better limit the total cost of my loans.
I understand that:
(1) If I am entering repayment on my loan for the first time and do not provide my loan holder with this completed
form and any other documentation required by my loan holder, or if I do not qualify for the repayment plan that I
requested, I will be placed on the standard repayment plan (see Section 9).
(2) If I am currently repaying my loan under a different repayment plan and want to change to the repayment plan I
selected in Section 2, my loan holder may grant me a forbearance for up to 60 days to collect and process
documentation supporting my request for the selected plan. I am not required to make loan payments during this
period of forbearance, but interest will continue to accrue. Unpaid interest that accrues during this forbearance
period will not be capitalized (see Section 9).
(3) If I am in a deferment or forbearance at the time I request one of the repayment plans listed in Section 2, my loan
holder may end the deferment or forbearance early to process my new repayment plan request.
(4) If I am delinquent in making payments under my current repayment plan at the time I request one of the
repayment plans listed in Section 2, my loan holder may grant me a forbearance to cover any payments that are
overdue, or that would be due, at the time my request is processed. Unpaid interest that accrues during this
forbearance period may be capitalized.
(5) If I am requesting the ICR plan, my initial payment amount will be the amount of interest that accrues each month
on my loan until my loan holder receives the income documentation needed to calculate my ICR payment
amount. If I cannot afford the initial interest payments, I may request forbearance by contacting my loan holder.
I authorize the loan holder to which I submit this request (and its agents or contractors) to contact me regarding my
request or my loan(s), including repayment of my loan(s), at the number that I provide on this form or any future
number that I provide for my cellular telephone or other wireless device using automated telephone dialing
equipment or artificial or prerecorded voice or text messages.
I certify that all of the information I have provided on this form and in any accompanying documentation is true,
complete, and correct to the best of my knowledge and belief.
Borrower Signature
Date
Spouse’s Signature (if required)
Date
Note: Your spouse’s signature is required if you completed Section 3 and/or completed Item 11.
SECTION 7: WHERE TO SEND THE COMPLETED REQUEST
Return the completed form and any required
If you need help completing this form, call:
documentation to:
(If no telephone number is shown, call your loan
(If no address is shown, return to your loan servicer.)
servicer.)
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