OMB No. 1845-0011
Form Approved
William D. Ford Federal Direct Loan (Direct Loan) Program / Federal Family
Exp. Date 8/31/2021
Education Loan (FFEL) Program
: Any person who knowingly makes a false statement or misrepresentation on this form or on
any accompanying document is subject to penalties that may include fines, imprisonment, or both, under
the U.S. Criminal Code and 20 U.S.C. 1097.
Please enter or correct the following information.
Check this box if any of your information has changed.
State Zip Code
Telephone - Primary
Telephone - Alternate
Email (Optional)
Carefully read the entire form before completing it.
To qualify, you must be a parent borrower of a Direct or Federal PLUS Loan that was first disbursed on or after July 1, 2008 and
the student on whose behalf you borrowed the PLUS Loan must be enrolled at least half time.
If you qualify, you may also defer repayment for the 6 months following the date that the student on whose behalf you
borrowed ceases to be enrolled at least half time.
I request:
To defer repayment of my PLUS Loans for the period during which I meet the eligibility criteria outlined in Section 2,
as certified by an authorized official in Section 4, and based on the student's enrollment (identified below):
Student's Name
If checked, to make interest payments on my loans during my deferment.
If checked, to defer repayment on my PLUS Loan for the 6-month period after the student identified above
graduates, withdraws, or is no longer enrolled on at least a half-time basis.
I understand that:
I am not required to make payments of loan principal or interest during my deferment.
My deferment will begin, as certified by the authorized official, on the date I became eligible for the deferment.
My deferment will end on the later of the date I am no longer eligible for the deferment or, if requested, following the
6-month period after the student is no longer enrolled on an at least half-time basis, graduates, or withdraws.
My loan holder may grant me a forbearance while processing my form or to cover any period of delinquency that
exists when I submit my form.
Unpaid interest may capitalize on my loans during or at the expiration of my deferment or forbearance.
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Borrower Name Borrower SSN
I certify that:
The information I have provided on this form is true and correct.
I will provide additional documentation to my loan holder, as required, to support my deferment eligibility.
I will notify my loan holder immediately when my eligibility for the deferment ends.
I have read, understand, and meet the eligibility requirements in Section 2.
I authorize
the entity to which I submit this request and its agents to contact me regarding my request or my loans at any
cellular telephone number that I provide now or in the future using automated telephone dialing equipment or artificial or
prerecorded voice or text messages.
Borrower's Signature
As an alternative to completing this section, you may attach separate documentation from an authorized official that
includes all of the information requested below or the school can report the student's enrollment to the National Student
Loan Data System (NSLDS) at
The student identified in Section 3 is enrolled:
The academic period for which I am certifying the
Full time
student's enrollment ends/ended on:
At least half time, but less than full time
The academic period for which I am certifying the
The student is expected to complete his/her
student's enrollment status begins/began on: program requirements on:
I certify, to the best of my knowledge and belief
, that the information that I have provided in this section is accurate.
Name of School OPEID
State Zip Code
Official's Name/Title Telephone
Official's Signature
Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Example: March 14, 2019 = 03-14-2019. Include
your name and account number on any documentation that you are required to submit with this form. This deferment is for
loans you borrowed for the student in Section 3. If you want to apply for a deferment on loans that you borrowed for another
student, or on loans that are held by different loan holders, you must submit a separate deferment request for the other
student or to each loan holder. If you have loans made jointly (as co-makers), both borrowers must individually meet the
requirements for a deferment and each of you must submit a separate deferment request.
Return the completed form and
any required documentation to the address shown in Section 7.
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American Education Services
P.O. Box 2461
Harrisburg, PA 17105-2461
Fax: 717-720-3916
If you need help completing this form, call:
(If no phone number is shown, call your loan holder.)
Or visit
Phone: 800-233-0557
William D. Ford Federal Direct Loan (Direct Loan)
includes Federal Direct Stafford/Ford (Direct
Subsidized) Loans, Federal Direct Unsubsidized Stafford/
Ford (Direct Unsubsidized) Loans, Federal Direct PLUS
(Direct PLUS) Loans, and Federal Direct Consolidation
(Direct Consolidation) Loans.
Federal Family Education Loan (FFEL) Program
includes Federal Stafford Loans, Federal PLUS Loans, Federal
Consolidation Loans, and Federal Supplemental Loans for
Students (SLS).
authorized official
who may complete Section 4 is
an official of the school where the student is/was enrolled.
is the addition of unpaid interest to the
principal balance of your loan. Capitalization causes more
interest to accrue over the life of your loan and may cause
your monthly payment amount to increase. Table 1 (below)
provides an example of the monthly payments and the total
amount repaid for a $30,000 unsubsidized loan. The
example loan has a 6% interest rate and the example
deferment or forbearance lasts for 12 months and begins
when the loan entered repayment. The example compares
the effects of paying the interest as it accrues or allowing it
to capitalize.
is one of the two individuals who are joint
borrowers on a Direct or Federal Consolidation Loan or a
Federal PLUS Loan. Both co-makers are equally responsible
for repaying the full amount of the loan.
is a period during which you are entitled
to postpone repayment of your loans. Interest is not
generally charged to you during a deferment on your
subsidized loans. Interest is always charged to you during a
deferment on your unsubsidized loans.
Table 1. Capitalization Chart
eligible school
is a school that has been
by the Department to participate in the Department's
Federal Student Aid programs, even if the school does not
participate in those programs.
is a period during which you are
permitted to postpone making payments temporarily,
allowed an extension of time for making payments, or
temporarily allowed to make smaller payments than
of your Direct Loans is the Department. The
holder of your FFEL Program loans may be a lender,
guaranty agency, secondary market, or the Department.
Your loan holder may use a servicer to handle billing and
other communications related to your loans. References to
“your loan holder” on this form mean either your loan
holder or your servicer.
subsidized loan
is a Direct Subsidized Loan, a Direct
Subsidized Consolidation Loan, a Federal Subsidized
Stafford Loan, and portions of some Federal Consolidation
unsubsidized loan
is a Direct Unsubsidized Loan, a
Direct Unsubsidized Consolidation Loan, a Direct PLUS
Loan, a Federal Unsubsidized Stafford Loan, a Federal PLUS
Loan, a Federal SLS, and portions of some Federal
Consolidation Loans.
Treatment of Interest with
Number of
Interest is paid
$30,000 $0 $30,000 $333 120 $41,767
Interest is capitalized at the
$30,000 $1,800 $31,800 $353 120 $42,365
Interest is capitalized
quarterly and at the end
$30,000 $1,841 $31,841 $354 120 $42,420
Return the completed form and any documentation to:
(If no address is shown, return to your loan holder.)
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Privacy Act Notice.
The Privacy Act of 1974 (5 U.S.C.
552a) requires that the following notice be provided to you:
The authorities for collecting the requested information
from and about you are §421 et seq. or §451 et seq. of the
Higher Education Act of 1965, as amended (20 U.S.C. 1071 et
seq. or 20 U.S.C. 1087a et seq.) and the authorities for
collecting and using your Social Security Number (SSN) are
§§428B(f) and 484(a)(4) of the HEA (20 U.S.C. 1078-2(f) and
1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the
William D. Ford Federal Direct Loan (Direct Loan) Program or
Federal Family Education Loan (FFEL) Program and giving us
your SSN are voluntary, but you must provide the requested
information, including your SSN, to participate.
The principal purposes for collecting the information on
this form, including your SSN, are to verify your identity, to
determine your eligibility to receive a loan or a benefit on a
loan (such as a deferment, forbearance, discharge, or
forgiveness) under the Direct Loan or FFEL Programs, to
permit the servicing of your loans, and, if it becomes
necessary, to locate you and to collect and report on your
loans if your loans become delinquent or default. We also
use your SSN as an account identifier and to permit you to
access your account information electronically.
The information in your file may be disclosed, on a case-
by-case basis or under a computer matching program, to
third parties as authorized under routine uses in the
appropriate systems of records notices. The routine uses of
this information include, but are not limited to, its disclosure
to federal, state, or local agencies, to private parties such as
relatives, present and former employers, business and
personal associates, to consumer reporting agencies, to
financial and educational institutions, and to guaranty
agencies in order to verify your identity, to determine your
eligibility to receive a loan or a benefit on a loan, to permit
the servicing or collection of your loans, to enforce the
terms of the loans, to investigate possible fraud and to verify
compliance with federal student financial aid program
regulations, or to locate you if you become delinquent in
your loan payments or if you default. To provide default rate
calculations, disclosures may be made to guaranty agencies,
to financial and educational institutions, or to state
agencies. To provide financial aid history information,
disclosures may be made to educational institutions.
To assist program administrators with tracking refunds
and cancellations, disclosures may be made to guaranty
agencies, to financial and educational institutions, or to
federal or state agencies. To provide a standardized method
for educational institutions to efficiently submit student
enrollment statuses, disclosures may be made to guaranty
agencies or to financial and educational institutions. To
counsel you in repayment efforts, disclosures may be made
to guaranty agencies, to financial and educational
institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the
Department of Justice, a court, adjudicative body, counsel,
party, or witness if the disclosure is relevant and necessary
to the litigation. If this information, either alone or with
other information, indicates a potential violation of law, we
may send it to the appropriate authority for action. We may
send information to members of Congress if you ask them
to help you with federal student aid questions. In
circumstances involving employment complaints,
grievances, or disciplinary actions, we may disclose relevant
records to adjudicate or investigate the issues. If provided
for by a collective bargaining agreement, we may disclose
records to a labor organization recognized under 5 U.S.C.
Chapter 71. Disclosures may be made to our contractors for
the purpose of performing any programmatic function that
requires disclosure of records. Before making any such
disclosure, we will require the contractor to maintain Privacy
Act safeguards. Disclosures may also be made to qualified
researchers under Privacy Act safeguards.
Paperwork Reduction Notice.
According to the
Paperwork Reduction Act of 1995, no persons are required
to respond to a collection of information unless such
collection displays a valid OMB control number. The valid
OMB control number for this information collection is
1845-0011. Public reporting burden for this collection of
information is estimated to average 15 minutes per
response, including time for reviewing instructions,
searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the
collection of information. The obligation to respond to this
collection is required to obtain a benefit in accordance with
34 CFR 682.210 or 685.204.
If you have comments or concerns regarding the
status of your individual submission of this form, please
contact your loan holder directly (see Section 7).
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