Loans Discharged Due To Disability Form - U.s. Department Of Education

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354 Richards Hall
fax: 617.373.8735
360 Huntington Ave
email: sfs@neu.edu
Boston, MA 02115
northeastern.edu/financialaid
Loan Discharge/Disability Verification
Student's Name:_______________________________________
NU ID:________________________
The U.S. Department of Education’s records indicate that you have one or more student loans
Instructions:
and/or TEACH grants discharged due to Total and Permanent Disability (TPD). If you are within the 3 year post
discharge monitoring period or conditional discharge period, your ability to obtain a new student loan may be
limited and will require the submission of several pieces of documentation before we can determine your
eligibility for federal loan funds.
Please review and check one of the following:
I do not want to be considered for federal student loan funds. STOP HERE – Sign and date below.
I want to be considered for federal student loan funds. I have completed this form and attached the following
required documentation:
The Physician’s Certification on page 2 is SIGNED by a qualified physician stating that I have the
ability to engage in substantial gainful employment.
Letter from the U.S. Department of Education or authorized loan servicer confirming that my loans
were discharged due to Total and Permanent Disability (TPD) AND which indicates if I am
currently in a post discharge or conditional discharge monitoring period and the beginning and
ending dates of that period.
The Borrower Statement on page 2 is signed and states that I understand that any new student loans
after my TPD discharge cannot be discharged for any present impairment.
I certify that the information included on this form is true and I am willing to provide additional
documentation if requested.
__________________________
________________________
Student’s Signature
Date

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