Request Form For Deferment Of Repayment - Federal Perkins Student Loan printable pdf download

REQUEST FOR DEFERMENT OF REPAYMENT

FEDERAL PERKINS (NDSL) STUDENT LOAN

NURSING STUDENT LOAN (NSL)

HEALTH PROFESSIONS/PRIMARY CARE LOAN (HPSL/PCL)

PART I -GENERAL INFORMATION TO BE COMPLETED BY BORROWER

Name:

Account Numbers (14 digits):

Address:

Email Address:

City:

Social Security Number:

State:

Zip Code:

Home Phone:

New Address

Work Phone:

Name of Lending Institution:

Deferment is requested from ________________________ to ___________________________. You MAY NOT have

form certified before status begins. All forms must be completed at least annually. Student deferment may not be

requested beyond the current school year.

Check the box for the type of deferment requested. Mark only ONE box for each loan type

NDSL/Federal Perkins

Enrolled as at least a half-time student in an

Member of U.S. Armed Forces on full

Full time volunteer in a tax exempt

institution of higher education

time active duty

organization

Pursuing a course of study in a graduate

Mother Returning to Workforce

Officer in Commissioned Corps of U.S.

fellowship training program (must be outside the

Public Health Service

U.S.)

Pursuing a course of study in a rehabilitation

Serving an eligible internship or

On active duty in National Oceanic and

program for disabled individuals

residency

Atmospheric Administration Corps

Nursing Student Loans

Enrolled as at least a half-time student in an accredited school of nursing

Member of the Peace Corps.

Enrolled as a full-time student in a course of study leading to an advanced degree

Member of a uniformed service (including NOAAC and

in nursing, or otherwise pursuing advanced professional training.

Public Health Service

(From degree ______________________ to degree _______________________)

Health

Health Professions/Primary Care/Loans for Disadvantaged Students

Professions/Primary Care/Loans for Disadvantaged Students

Pursuing a full time course of study at a school of medicine, osteopathy, dentistry,

Interrupting my studies to pursue a directly related health

pharmacy, podiatry, optometry, or veterinary medicine leading to a diploma,

profession educational activity

baccalaureate degree or equivalent degree.

Pursing advanced professional training including internships and residencies in the

Member of a uniformed service (including NOAAC and

field of ____________________________________

Public Health Service

Participating in a fellowship training program or related educational activities

Member of the Peace Corps

I claim exemption from payment of principal and accrual of interest on my student loan during the period

indicated above. I agree to notify the lending institution immediately if my status changes during this

period.

Signature of Borrower

Date

Request Form For Deferment Of Repayment - Federal Perkins Student Loan

Related Articles

Related forms

Related Categories