125 Thomas Boyd Hall Baton Rouge, LA 70803 P 225-578-3092 F 225-578-3969 perkinsloan@lsu.edu
Louisiana State University
Office of Accounting Services
Bursar OperationsPerkins Loan
125 Thomas Boyd Hall
FEDERAL PERKINS LOAN PROGRAM APPLICATION FOR FORBEARANCE
WARNING: Any person who knowingly makes a false statement or misrepresentation on this form shall be subject to a
fine of no more than $10,000 or imprisonment for not more than five years or both, under the provision of Sec. 20 U.S.C.
1097.
A. BORROWER INFORMATION
The following documentation is required to be attached and submitted with this application in order to process
the request for forbearance. Final responsibility for completion and return of this form and documentation rests
solely with the borrower.
Documentation of your most recent total monthly gross income (i.e. pay stub).
Documentation of your most recent monthly payments due on your post-secondary education loans
obtained through a federal education loan program.
Documentation appropriate to your situation.
Note: An institution shall grant a borrower forbearance of principal and, unless otherwise indicated by the
borrower, interest upon receipt of a written request and acceptable supporting documentation. Please note that
though payments are deferred, interest continues to accrue and will be due with the first payment following the
forbearance. Forbearance is renewable at intervals of six (6) months for periods that collectively do not exceed
(3)
y
ears.
B. REQUEST FOR FORBEARANCE (To be completed by the borrower)
I am requesting forbearance due to the following reasons:
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I c
ertify that: (1) The documentation I have submitted is true and correct; (2) I will provide additional
documentation, as required, to Louisiana State University to support my request for forbearance; (3) I will notify
Louisiana State University immediately when the condition(s) that qualified me for forbearance ends; (4) I have
read and understand the terms and conditions of forbearance; and (5) All statements made to support my
request for forbearance are true and correct.
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Signature of Borrower Date
Name LSU ID
Mailing Address Phone Number
City State Zip Code