EDUCATION RELATED DEFERMENT REQUEST
Federal Family Education Loan Program
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents
shall be subject to penalties which may include fines, imprisonment or both, under the U.S. Criminal Code and 20 U.S.C. §1097.
Please enter or correct the following information.
City, State, Zip ___________________________________________________
Telephone - Home ( ) _________________________________________
Telephone - Other ( ) _________________________________________
E-mail Address (Optional) __________________________________________
SECTION 1: BORROWER IDENTIFICATION
SECTION 2: DEFERMENT REQUEST
SECTION 3: BORROWER UNDERSTANDINGS AND CERTIFICATIONS
Page 1 of 3
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 5, 6, and 7.
n I meet the qualifications stated in Section 7 for the deferment checked below and request that my loan holder defer repayment of my loan(s):
For all FFEL Program borrowers:
r While I am engaged in a full-time course of study in a GRADUATE FELLOWSHIP program.
r While I am engaged in a full-time REHABILITATION TRAINING program.
For borrowers with an outstanding balance on at least one FFEL Program loan that was made before July 1, 1993, or who had an outstanding balance on a
loan made before July 1, 1993, when he or she obtained a loan on or after July 1, 1993:
r While I am engaged in an INTERNSHIP/RESIDENCY* program at an institution of higher education, hospital, or health care facility.
r While I am engaged in an INTERNSHIP/RESIDENCY* program at any other institution or organization. Name of Internship/Residency
* Federal PLUS Loans qualify for INTERNSHIP/RESIDENCY deferments only if they were made before August