A.M. Money
Economic Hardship Deferment Request
SECTION 1: BORROWER INFORMATION
Please enter or correct the following information:
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SSN
Name
Address
City, State, Zip
Telephone
Email
SECTION 2: DEFERMENT REQUEST
Please read the information below before continuing:
Maximum cumulative eligibility is 12 months per loan program.
You may pay more over the life of the loan if you elect into a period of Economic Hardship
Deferment.
If you need help, contact your servicer at 800-233-0557, for free assistance.
SECTION 3: QUESTIONNAIRE
What is your current job? In what city & state do you work?
What is your yearly income?
How many people live in your home with you? (Spouse and dependents only)
What kind of relief do you need? Choose as many as apply to you:
One-time setback (e.g. car broke down, moving across the country, etc.)
Short term (e.g. working a temporary job while you search for a more permanent one)
Long term (e.g. went to med school, but dropped out to change careers)
Unknown (e.g. recently unemployed)
When do you think you will be able to go back to making full payments?
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Initial request Renewal request
AMEHD/APDS
A.M. Money
Economic Hardship Deferment Request
SECTION 4: BORROWER REQUESTS, UNDERSTANDINGS,
AUTHORIZATION, AND CERTIFICATION
If I am requesting a period of Economic Hardship Deferment (EHD), I request:
To defer repayment of my loan(s) for the period during which I have an economic hardship.
That my deferment begin on:
I understand that:
I am not required to make payments of loan principal or interest during my deferment.
The EHD is granted in intervals determined by the owner and that forbearance may be
used for any delinquency period prior to the effective date of this deferment period.
My deferment will begin on the later of the date I became eligible or the date that I requested.
My deferment will end on the earlier of the date that I exhaust my maximum eligibility or the
certified deferment end date.
My deferment will be granted in increments of three (3) months. If I continue to be eligible for an
EHD after three (3) months, I may reapply, subject to the cumulative maximum.
Interest will capitalize on my loan(s) at the expiration of my deferment.
I certify that all of the information I have provided on this form and in any accompanying
documentation is true, complete, and correct to the best of my knowledge and belief.
I am unable to remit the monthly installment payment amounts required by my Promissory Note(s). I
agree to defer my loan payments in accordance with the terms of this EHD, as determined at the sole
discretion of my loan holder and American Education Services (AES). At any time, I may make a
payment. I reaffirm all terms and conditions of my Promissory Note. I consent to the lender and any
other owner, holder, servicer, guarantor or insurer of my account to contact me about my account via
auto-dialer or similar device and/or using a prerecorded or artificial voice or message for any lawful
purpose utilizing any cellular telephone number(s) I provide, even if I am charged for the call under
my phone plan. Providing my mobile or alternative telephone number(s) and electronic mail
address(es) to the lender is voluntary and I am under no obligation to do so. If I do not elect to
provide a mobile or alternative telephone number, or electronic mail address, it will not affect the
consideration or disposition
of my EHD request.
Date
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Borrower's Signature