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Unemployment Deferment Form

The Unemployment Deferment.pdf form is used in order to allow the borrower on a debt to postpone payments of the mentioned debt due to being out of a job. In the case of this happening, you are required to fill and submit the following form.

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UNEM	 	
UNEMPLOYMENT DEFERMENT REQUEST   
William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family Education Loan (FFEL) Program 
 WARNING: Any person who knowingly makes a false statement or misrepresent ation on this form or on any accompanying document is subject  to 
penalties that may include fines, imprisonment, or bot h, under the U.S. Criminal Code and 20 U.S.C. 1097.	 	
 	
SECTION 1: BORROWER IDENTIFICATION 
 	Please enter or correct the following information.  
 	 Check this box if any of your information has changed. 	 	 	SSN 	 	 	 	- 	 	 	- 	 	 	 	 	 	Name 	 	 	Address 	 	 	City, State, Zip Code 	 	 	Telephone – Primary     (        ) 	 	 	Telephone – Alternate  (        ) 	 	 	E-mail Address (Optional) 	 	 	 	
SECTION 2: DEFERMENT REQUEST 
Before completing this form, carefully read the entire form, including the instructions and other information in Sections 4, 5,  and 6. 
„  I meet the eligibility requirements stated in Section 6 for an  Unemployment Deferment and request that my loan holder defer repayment of my loan(s).  To document eligibility, 
complete the following:  
(1)   I became unemployed or began working less t han full time (as defined in Section 5) on 	
|_____|_____|-|_____|_____|-|_____|_____|_____|_____|	.   Except as explained in 
Section 3, my deferment begins on this date unless I r equest my deferment to begin on the following later date:  	
|_____|_____|-|_____|_____|-|_____|_____|_____|_____|	.   
(2)   Check ONE of the boxes below: 
(A)   	
   I am diligently seeking but unable to fi nd full-time employment in the United States (as defined in Section 5) in any field  or at any salary or responsibility level.  I am 
registered with a public or priv ate employment agency if there is one within 50 mi les of my current address. Further, if I am requesting an extension of an existing 
Unemployment Deferment, I have made at least six diligent attempts to find full-time employment in the most recent 6 months. 
NOTE :  School placement offices and “temporar y employment” agencies do not qualify as public or private employment agencies. 
OR 
(B)   
   I am eligible for unemployment benefits, and I have attached  documentation of my eligibility for these benefits.  The documentation includes my name, address, and 
social security number, and shows that I am eligible to receive unemployment benefits during t he period for which I am requesting deferment.	 	
SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION  
„ I understand that:  
(1)  I am not required to make pay ments of loan principal during my deferment.  Interest will  not accrue on my subsidized loan(s) d uring my deferment.  However, interest will 
accrue on my unsubsi dized loan(s).   
(2)  I may pay the interest that accrues on my unsubsidized loan(s) during my deferment. I may choose to make interest payments by checking the box below.   My loan holder may 
capitalize interest that I do not pay during the deferment period on my unsubsidized loan(s). 	
  I wish to make interest payments on  my unsubsidized loan(s) during my deferment. 
(3)  My deferment will begin on the date I becam e unemployed or began working less than full time, as shown in Section 2, unless I  request my deferment to begin on a later date.  
However, if this is my first Unemployment Deferment request fo r my current period of unemployment and I am not providing docume ntation of my eligibility for unemployment 
benefits, my deferment will begin no more than 6 months before the date my loan holder receives this request, even if I became  unemployed or began working less than full 
time more than 6 months ago. 
(4)  My deferment will end on the earlier of the date I obtain full-time  employment or the date on which I exhaust my maximum cumul ative eligibility.  My deferment will last for no 
more than 6 months after the date my loan holder receives the deferment request.   
(5)  My maximum cumulative eligibility is: 
•   For  Direct Loan Program borrowers:   36 months. 
•   For  FFEL Program borrowers:  (a)  36 months if I did not have an outstanding balance  on a FFEL Program loan that was first disbursed before July 1, 1993 when I obtained 
a FFEL Program loan  on or after July 1, 1993;  or (b) 24 months if my first l oan(s) were first disbursed  before July 1, 1993. 
  (6)  If my deferment does not cover all my past due payments, my  loan holder may grant a forbearance on my loan( s) for all payments due before the begin date of my deferment. 
If the period for which I am eligible for a deferment has ended,  my loan holder may grant a forbearance on my loan(s) for all payments due when my deferment request is 
processed.  Interest that accrues dur ing this forbearance may be capitalized. 
(7)  My loan holder may grant a for bearance on my loan(s) for up to 60 days, if nec essary, for the collection and processing of documentation related to my deferment request.  
Interest that accrues during this  forbearance will not be capitalized. 
„  I certify that:  (1)  The information I have provided on this form is true and correct.  (2) I will provide additional documentation to my loan holder, as required, to support my 
deferment status.  (3) I will notify my loan holder immedi ately when the condition that qualified me for the deferment ends.   (4) I have read, understand, and meet the eligibility 
requirements of the deferment for which I  have applied, as explained in Section 6. 
„   I authorize the entity to which I submit this request (i.e., the school,  the lender, the guaranty agency, the U.S. Department of Education, and their respective agents and 
contractors) to contact me r egarding 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. 
 	
Borrower’s Signature  
  Date
 
 	
OMB No. 1845-0011 
Form Approved 
Exp. Date 7/31/2015

SECTION 4: INSTRUCTIONS FOR COMPLETING THE FORM 
Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: January 31, 2012 = 01-31-2 012. Include your name and account number on 
any documentation that you are required to submit with this form.  If you need help completing this form, contact your loan holder. If you want to apply for a deferment on loans that are 
held by different loan hol ders, you must submit a separate def erment request to each loan holder. 
Return the completed form and any required documentation to the address shown in Section 7.   
SECTION 5: DEFINITIONS  
„  Capitalization is the addition of unpaid interest to the principal balance of y our loan. The principal balance of a loan increases when paymen ts are postponed during periods of 
deferment or forbearance and unpaid interest is capitalized. As a re sult, more interest may accrue over the life of the loan, the monthly payment amount may be higher, or more 
payments may be required. The chart below pr ovides estimates, for a $15,000 unsubsidized loan balance at a 6.8% interest rate,  of the monthly payments due following a 12-month 
deferment that started when the loan entered  repayment. It compares the effects of paying the interest as it accrues, capitaliz ing the interest at the end of the deferment, and 
capitalizing interest quarterly and at the end of the deferment . Please note that the U.S. Department of Education (the Department) and many other holders do not capitalize interest 
on a quarterly basis.  The actual loan in terest cost will depend on your interest rate, length of the deferment, and frequency of capitalization. Paying in terest during the period of 
deferment lowers the monthly payment by about $12 and saves about $426 over the lifetime of the loan, as depicted in the chart  below. 
Treatment of Interest Accrued   During Deferment  Loan  
Amount  Capitalized Interest 
 for 12 Months  Principal to 
 Be Repaid  Monthly 
 Payment  Number of  
Payments  Total Amount 
 Repaid  Total Interest  
Paid 	
Interest is paid  $15,000.00 $0.00 $15,000.00 $172.62 120 $21,736.55*  $6,730.66 
Interest is capitalized at the end of deferment  $15,000.00 $1,022.09 $16,022.09 $184.38 120 $22,125.94  $7,119.64 
Interest is capitalized quarterly during 
deferment and at the end of deferment  $15,000.00 $1,048.51 
$16,048.51 $184.69 120 $22,162.41  $7,156.10 	
  *Total amount repaid includes $1,022.09 of interest paid during the 12-month period of deferment.  
„   A  deferment  is a period during which you are entitled  to postpone repayment of the principal balance of your loan(s). Interest does not ac crue during a deferment on a Direct 
Subsidized Loan, a Direct Subsidized Consolidation Loan, a subsidized Federal Stafford Loan, or, in some cases, the subsidized  portion of a Federal Consolidation Loan (see Note). 
Interest does accrue during a deferment on  a Direct Unsubsidized Loan, a Direct PLUS Loan, a Direct Unsubsidized Consolidation  Loan, an unsubsidized Federal Stafford Loan, a 
Federal PLUS Loan, or a Federal SLS Loan.  Note: Interest does not accrue on a Federal C onsolidation Loan during a deferment only if:  (1) the application for the Federal 
Consolidation Loan was received by your loan holder on  or after January 1, 1993, but before August 10, 1993; (2) the application was received by y our loan holder on or after August 
10, 1993, and the Federal Consolidation Loan includes only  Federal Stafford Loans that were eligible for federal interest subsidy; or (3) the application was received by your loan 
holder on or after November 13, 1997, in which case interest does not accrue on the portion of  the Federal Consolidation Loan that paid a subsidized Direct Loan or FFEL Program 
loan(s).  
„   The Federal Family Education Loan (FFEL) Program  includes Federal Stafford Loans, Federal PLUS Loans, Federal Consolidation Loans, and F ederal Supplemental Loans for 
Students (SLS).  
„  A  forbearance is a period during which you ar e permitted to temporarily postpone making payments, allowed an extension of time for making pa yments, or temporarily allowed to 
make smaller payments than scheduled. 
„  Full-time  employment  is defined as working at least 30 hours per week in a position expected to last at least 3 consecutive months. 
„  The  holder  of your Direct Loan Program l oan(s) is the the Department. The holder of your  FFEL Program loan(s) may be a lender, guaranty agency, secondary market, or the 
Department. 
„  The  United States,  for the purpose of this deferment, includes any state of the Uni on, the District of Columbia, the Commonwealth of Puerto Rico,  American Samoa, Guam, the 
Virgin Islands, the Commonwealth of the Northern Mariana Islands, the Freely Associated States (the Republic of the Marshall Is lands, the Federated States of Micronesia, and the 
Republic of Palau), and U.S. military bases and embassy compounds in foreign countries.  
„  The  William D. Ford Federal Direct Loan (Direct Loan) Program  includes Federal Direct Stafford/Ford (Direct Subsidized) Loans, Federal Direct Unsubsidized Stafford/Ford 
(Direct Unsubsidized) Loans, Federal Direct PLUS (Direct PLUS) Loans, and Federal Direct Consolidation (Direc t Consolidation) Loans. 
SECTION 6: ELIGIBILITY REQUIREMENTS  
„ To qualify: 
(1)  You must be diligently seeking but unable to find full-time employment in the United States (as defined in Section 5) in any fi eld or at any salary or responsibility level.  You must 
be registered with a public or pr ivate employment agency if there is one within 50  miles of my current address.  Further, if you are requesting an extension of an existing 
Unemployment Deferment, you must have made at  least six diligent attempts to find full-time employment in the most recent 6 months.  (Check box A in Section 2.)  
       NOTE:   School placement offices and “temporary employment” agencies do not qualify as public or private employment agencies. 
OR 
(2)  You must be eligible for unemployment benefits, and attach document ation of your eligibility for these benefits.  The documentation must include your name, address, and social 
security number, and show that you are eligible to receive unemployment benefits during the per iod for which you are requesting deferment.  (Check box B in Section 2.)	
 
 	
SECTION 7: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST  
Return the completed form and any required documentation to: (If no address is shown, return to your loan holder.)  
                                        U.S. Department of Education 
                                                                    FedLoan Servicing 
                                                                    P.O. Box 69184 
                                                                    Harrisburg, PA 17106-9184 
                                                                        	Or Fax to: 	717-720-1628	  If you need help completing this form, call: 	
800-699-2908	 
(If no telephone number is show n, call your loan holder.) 
If you are calling internationally, call:	
 717-720-1985	 	If you use a telecommunications device for the deaf (TDD), call:	 800-722-8189	 
 
 
Web site:  www.MyFedLoan.org

Page 3 of 3 	
 	
SECTION 8: IMPORTANT NOTICES 
Privacy Act Notice.  The Privacy Act of 1974 (5 U.S.C. 552a) requi res that the following notice be provided to you: 
The authorities for collecting the request ed information from and about you are §421 et seq.  and §451 et seq. of the Higher Education Act of 1965, as amended (20 U.S.C. 1071 et 
seq.  and 20 U.S.C. 1087a  et seq.) and the authorities for collecting and using your Social Securi ty Number (SSN) are §§428B(f) and 484(a)(4) of the HEA (20 U.S .C. 1078-2(f) and 
1091(a)(4)) and 31 U.S.C. 7701(b).  Participati ng in the Federal Family Education Loan (FFEL) Program or the William D. Ford Federal Direct Loan (Direct Loan) Program and giving 
us your SSN are voluntary, but you  must provide the requested information,  including your SSN, to participate. 
The principal purposes for collecting the in formation on this form, including your SSN,  are to verify your identity, to determine your eligibility to receive a loan or a benefit on a loan 
(such as a deferment, forbearance, dischar ge, or forgiveness) under the FFEL and/or Di rect Loan Programs, to permit the servicing of your loan(s), and, if it becomes necessary, to 
locate you and to collect and report on your l oan(s) if your loan(s) becomes delinquent  or defaults.  We also use your SSN as an account identifier and to permit you to access your 
account information electronically. 
The information in your file may be disclosed, on a case-by-case basis or under a computer matchi ng program, to third parties as authorized under routine uses  in the appropriate 
systems of records notices.  The routine uses of this information include, but are not limited to, its disclosure to federal, s tate, or local agencies, to private parties such as relatives, 
present and former employers,  business and personal associates,  to consumer reporting agencies, to financial and educational in stitutions, and to guaranty agencies in order to verify 
your identity, to determine your eligibility to receive a loan or a benefit on a loan, to permit  the servicing or collection of your loan(s), to enforce the term s of the loan(s), to investigate 
possible fraud and to verify compliance with federal student financial aid program regulations, or to  locate you if you become delinquent in your loan payments or if you default.  To 
provide default rate calculati ons, disclosures may be made to guaranty agencies, to financial and educational institutions, or  to state agencies.  To provide financial aid history 
information, disclosures may be made to educ ational institutions.  To assist program administrators with tracking refunds and c ancellations, disclosures may be made to guaranty 
agencies, to financial and educational institutions, or to federal or state agencies.  To prov ide a standardized method for educational institutions to efficiently submit student enrollment 
statuses, disclosures may be made to guarant y agencies or to financial and educational institutions.  To counsel you in repayme nt efforts, disclosures may be made to guaranty 
agencies, to financial and educational institutions, or to federal, state, or local agencies.  
In the event of litigation, we may send records to the Department of Justice, a court, adjudica tive body, counsel, party, or witness if the disclosure is relevant and necessary to the 
litigation.  If this information, either  alone or with other information, indicates a potential viol ation of law, we may send it to the appropriate authority for action.  We may send 
information to members of Congress if you ask them to help y ou with federal student aid questions.  In circumstances involving employment complaints, grievances, or disciplinary 
actions, we may disclose relevant records to adjudicate or inve stigate the issues.  If provided for by a collective bargaining  agreement, we may disclose records to a labor organization 
recognized under 5 U.S.C. Chapter 71.  Di sclosures may be made to our contractors for the purpose of performing any programmatic function that requires di sclosure of records.  
Before making any such disclosure, we will  require the contractor to maintain Privacy Act safeguards.  Disclosures may also be  made to qualified researchers under Privacy Act 
safeguards. 
Paperwork Reduction Notice.  According to the Paperwork Reduction Act of 1995, no persons  are required to respond to a collection of information unless it displays a currently 
valid OMB control number.  Public reporting burden for this coll ection of information is estimated to average 0.25 hours (15 minutes) per response, including the time for reviewing 
instructions, searching existing data re sources, gathering and maintaining the dat a needed, and completing and reviewing the in formation collection.  Individuals are obligated to 
respond to this collection to obtain a benefit in accordance  with 34 CFR 682.210 or 685.204.  Send comments regarding the burde n estimate(s) or any other aspect of this collection of 
information, including suggestions for reduc ing this burden to the U.S. Department of Education, 400 Maryland Avenue, SW, Washi ngton, DC 20210-4537 or e-mail 
ICDocketMgr@ed.gov and reference OMB Control Number 1845-0011.   Note: Please do not return the completed form to this address. 
 
If you have questions regarding the status of your individual s ubmission of this form, contact your loan holder (see Section 7) .
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