SC-NGUN-PS
AES Special Programs
Unemployment Deferment Request
AES Graduate and Professional Services
P.O. Box 2461
Harrisburg, PA 17105-2461
Fax: 717-720-3916
Please enter or correct the following information. If correction, check this box:
Account Number
Name
Address
City, State, Zip
Telephone -- Home
Telephone -- Mobile
Section 1 - Deferment Request - Must be completed by borrower. See definitions and eligibility criteria in the preceding cover letter.
I meet the qualifications stated for Unemployment Deferment and request that AES defer repayment of my loan(s) while I am unemployed. (Maximum eligibility is a
single period no to exceed 36 months).
To document eligibility, the following must be completed:
1) I became unemployed or began working less that 30 hours per week on (MM-DD-YY)
2) Check one:
.
I registered with the following public or private employment agency:
(Please print or type. School placement offices and "temporary" agencies do not qualify as public or private employment agencies.)
I am not registered with an employment agency because there is not one within 50 miles of my permanent or temporary address.
Name of Employment Agency Address (City, State, Zip) Telephone
I consent to the lender and any other owner, holder, servicer, guarantor or insurer of my accout to contact me about my account via autodialer or similar device and/or
using a prerecorded or artificial voice or message for an 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 deferment
request.
If checked, to make interest payments on my loans during my deferment.
Borrower Understandings and Certifications
I understand that: (1) AES will not grant this deferment request unless all application sections sections of this form are completed and; (2) Principal and interest
payments will be deferred I understand that any interest which accrues during my deferment period will be capitalized to the extent such amounts are not paid by me
prior to the conclusion of any approved deferment periods. This will increase the principal balance of my account.
I certify that: (1) The information provided in Section 1 above is true and correct; (2) I will notify AES immediately when the condition that qualified me for the
deferment ends; and (3) I have read, understand, and meet the conditions of the deferment for which I have applied.
Borrower Signature Date
3) My temporary address is (please print or type if applicable):
Street
City, State, Zip
Telephone
4) In the six months, I have made attempts to secure full-time (see Definitions) employment at the following six firms (not required for the initial period of
unemployment).
Name of Firm
Street
City
State Zip
Contact Person (Name or Title)
Telephone
Return completed form to address listed above
Name of Firm
Street
City
State Zip
Contact Person (Name or Title)
Telephone
Name of Firm
Street
City
State Zip
Contact Person (Name or Title)
Telephone
Name of Firm
Street
City
State Zip
Contact Person (Name or Title)
Telephone
Name of Firm
Street
City
State Zip
Contact Person (Name or Title)
Telephone
Name of Firm
Street
City
State Zip
Contact Person (Name or Title)
Telephone
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