Financial Aid Office P.O. Box 309 Jamestown, NC 27282
Phone: 336.334.4822 Option 3 Fax: 336.217.8468
2018-2019 Disability Statement for Student Loans
Student Name:
GTCC ID:
Phone:
Directions: If a borrower whose prior loan was discharged due to a total and permanent disability wishes to take
out another Federal student loan, he must:
1. Obt
ain a physician’s certification that he has the ability to engage in substantial gainful activity
, and
2.
Sign a statement acknowledging that the new Federal student loan can’t later be discharged for any present
impairment unless it deteriorates so that he is again totally and permanently disabl
ed.
Statement:
By my signature below, I acknowledge that the new Federal loan that I plan to borrow can’t later be
discharged for any present impairment unless it deteriorates so that I am again totally and permanently
disabled.
☐ Physician’s statement attached.
☐ Physician’s statement is already on file with GTCC.
Certification and Signatures
WARNING: If you purposely give false or
Signing this worksheet certifies that all of the information you reported on it
misleading information you may be fined,
be sentenced to jail, or both.
Student’s Signature Date
Please return this completed form to: GTCC Financial Aid Office, PO Box 309, Jamestown, NC 27282
or FAX to 336-217-8468.
click to sign
signature
click to edit
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