Request For Cancellation Benefit Or Deferment Prior To Cancellation

FEDERAL PERKINS (NDSL) STUDENT LOAN CANCELLATION OR DEFERMENT REQUEST

To qualify for the cancellation benefits listed below you must serve in an eligible capacity for a full year (or if

teaching, for a complete academic year or two consecutive semesters). While you complete your year of

service/employment, you may defer the payments that would come due. Upon receipt of your completed form, we

will make a preliminary determination of your eligibility for cancellation. If it is determined that you will not qualify

for cancellation, we will deny your deferment request and payments will be due as billed. If it is determined that

you will be eligible for cancellation, we will suspend billing for payments due during your year of

service/employment. At the end of your year of teaching/service/employment, you must provide documentation of

having fulfilled the requirements in order to receive partial cancellation of your loan.

NOTE: A form may be submitted at the beginning of the year of

service/employment to Defer payments while eligible service is

performed. A second form may be submitted upon completion of the

year to receive partial Cancellation . All forms must cover a complete

year; partial years do not qualify you for cancellation.

Please note :

You may use a single form to cover both the benefit year that

has passed (cancellation) and may be used to cover the

upcoming year of service/employment (deferment). It will depend

upon your contract and your employer’s ability to certify the

form.

Cancellation Benefit Pertaining to Midwestern Graduates

Working as a Nurse or Medical Technician providing health care services. To qualify as a Nurse, you must be an

LPN, RN, or otherwise licensed by an appropriate State agency to provide nursing services. To qualify as a Medical

Technician, you must be certified, registered, or licensed by the governing State agency in the State where

you provide service. You must be employed as an allied health professional working in a field such as

therapy, dental hygiene, medical technology, or nutrition. You must assist, facilitate, or complement the work

of physicians or other specialists in the health care system.

INSTRUCTIONS

Parts I-III must be completed by the borrower. Part IV must be completed by your employer. (We will return

it unprocessed if any information is missing.)

Indicate your request for Deferment or Cancellation or both.

Sign and date the form ( REQUIRED ). If your signature is missing, the form will be returned.

Have your employment/service dates and your job duties certified by an official of the appropriate

organization. If an official seal or stamp of the organization is not available, your employer/organization must

submit verification of your service/employment on organization letterhead.

If you changed employers during the year, you must submit a cancellation form from each employer. In

addition, there may be NO BREAKS between periods of employment.

Return forms and supporting documentation to:

MIDWESTERN UNIVERSITY

SFS-Loan Repayment Office

555 31st Street

Downers Grove, IL 60515

Tel: 866-729-2698 * 630-515-6352 * 630-515-6353

Request For Cancellation Benefit Or Deferment Prior To Cancellation - State Of Illinois Page 3