Public Service Loan Forgiveness (Pslf): Employment Certification Form Page 3
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6SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM
You may submit information about multiple employers by submitting one copy of Sections 1 and 2 (Page 1), and one copy of
Sections 3 and 4 (Page 2) per employer. When completing this form, type or print using dark ink. Enter dates as month-day-
year (mm-dd-yyyy). Use only numbers. Example: March 14, 2016 = 03-14-2016. If any information is crossed out or altered in
Section 3, it must be initialed by your employer. For more information about PSLF and how to use this form, visit
StudentAid.gov/publicservice. Return the completed form to the address shown in Section 7.
SECTION 6: DEFINITIONS
AmeriCorps position means a position approved by the
Peace Corps position means a full-time assignment
Corporation for National and Community Service under
under the Peace Corps Act as provided for under 22 U.S.C.
Section 123 of the National and Community Service Act of
2504.
1990 (42 U.S.C. 12573).
Public education includes services that provide
An authorized official is an official of a public service
educational enrichment or support directly to students or
organization (including AmeriCorps or the Peace Corps)
their families in a school or a school-like setting.
who has access to the borrower's employment or service
Public interest legal services refers to legal services
records and is authorized by the public service organization
that are funded in whole or in part by a local, State, Federal,
to certify the employment status of the organization's
or Tribal government.
employees or former employees, or the service of
Public health includes nurses, nurse practitioners,
AmeriCorps or Peace Corps volunteers.
nurses in a clinical setting, and full-time professionals
Eligible loans are loans that are not in default and made
engaged in
health care practitioner occupations
and
health
under the William D. Ford Federal Direct Loan (Direct Loan)
support
occupations, as such terms are defined by the
Program.
Bureau of Labor Statistics.
Early childhood education includes licensed or
A public service organization is a private not-for-profit
regulated child care, Head Start, and State funded pre-
organization that is not a labor union or a partisan political
kindergarten.
organization and that provides at least one of the following
An employee means an individual who is hired and paid
public services: (1) emergency management, (2) military
by the organization.
service, (3) public safety, (4) law enforcement, (5) public
Full-time means working in qualifying employment in
interest legal services, (6) early childhood education, (7)
one or more jobs for the greater of: (1) An annual average of
public service for individuals with disabilities and the
at least 30 hours per week or, for a contractual or
elderly, (8) public health, (9) public education, (10) public
employment period of at least 8 months, an average of 30
library services, (11) school library services, or (12) other
hours per week; or (2) Unless the qualifying employment is
school-based services.
with two or more employers, the number of hours the
Qualifying payments are separate, on-time, full monthly
employer considers full time.
payments made on a Direct Loan after October 1, 2007
Government includes a Federal, State, local or Tribal
under a qualifying repayment plan.
government organization, agency or entity; a public child or
Qualifying employment includes employment by the
family service agency; or a Tribal college or university.
government, employment by a not-for-profit organization
An on-time payment is a payment made no more than
that is tax-exempt under Section 501(c)(3) of the Internal
15 days after the due date for the payment.
Revenue Code, AmeriCorps position, a Peace Corps position,
Law enforcement means service performed by an
or employment at a public service organization.
employee of a public service organization that is publicly
Qualifying repayment plans include the Revised Pay As
funded and whose principal activities pertain to crime
You Earn (REPAYE) plan, the Pay As You Earn (PAYE) plan,
prevention, control or reduction of crime, or the
the Income-Based Repayment (IBR) plan, the Income-
enforcement of criminal law.
Contingent Repayment (ICR) plan, the 10-Year Standard
Military service means service on behalf of the U. S.
Repayment plsn (Standard Repayment plan with a
Armed Forces or the National Guard performed by an
maximum 10-year repayment period), and any other Direct
employee of a public service organization.
Loan repayment plan, but only if payments are at least equal
to the monthly payment amount that would be required
under the Standard Repayment plan with a 10-year
repayment period.
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