Fill - Free fillable Perkins Military Deferment Request (Marquette University) PDF form

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MIL

MILITARY SERVICE AND POST-ACTIVE DUTY STUDENT

DEFERMENT REQUEST

William D. Ford Federal Direct Loan (Direct Loan) Program/Federal Family

OMB No. 1845-0080

Form Approved

Exp. Date 9/30/2016

Education Loan (FFEL) Program/Federal Perkins Loan (Perkins Loan) Program

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or any

accompanying document is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal

Code and 20 USC 1097.

SECTION 1: BORROWER IDENTIFICATION

Please enter or correct the following information.

Check this box if any of your information has changed.

SSN

Name

Address

City, State, Zip Code

Telephone – Primary

Telephone – Alternative

E-mail (optional)

___ ___ ___ - ___ ___ - ___ ___ ___ ___

_________________________________

( _______ ) _______ - _____________

_________________________________

___

SECTION 2: DEFERMENT REQUEST

Before completing this form, carefully read the entire form, including the instructions and other information in

Sections 5, 6, and 7. For the Military Service Deferment, a representative may complete and sign this form on your

behalf if you are unable to do so. Check the appropriate box(es) for the deferment(s) you are requesting. For the Post-

Active Duty Student Deferment, enter the required information in the space provided.

Note: If you are a member of the National Guard (including a member in retired status) during a time when a governor

activated National Guard personnel for active state duty for a period of more than 30 consecutive days and qualify

for a Post-Active Duty Student Deferment, but not the Military Service Deferment, you may request forbearance

for your period of active duty service.

If you have loans that you obtained before going on active duty military service, you may be eligible to limit the interest

rate on your loans to 6% during the period of your active duty military service under the Servicemembers Civil Relief Act

(SCRA). To request a limited interest rate, submit a written request to your loan holder and provide a copy of your

military orders.

(A) Military Service Deferment. I request that my loan holder defer repayment of my eligible loan(s) beginning on

the date I began performing the military service that qualifies me for the deferment and ending 180 days

following completion of my qualifying military service.

(B) Post-Active Duty Student Deferment. I request that my loan holder defer repayment of my eligible loan(s)

following the completion of my qualifying active duty service and any applicable grace period. My deferment will

end the earlier of:

(a) The date I resume enrollment at an eligible school on at least a half-time basis; or

(b) 13 months following the completion date of my active duty service and any applicable grace period.

If I am also granted a Military Service Deferment, the 180-day period described in Item A above will run at the

same time as my Post-Active Duty Student Deferment period. Therefore, I will receive no more than 13 months

of deferment following the completion of my qualifying military service.

Enter the name of the school where you were enrolled on at least a half-time basis when you were called to

active duty or within 6 months before the date you were called to active duty, and the date you were last

enrolled at least half time at the school:

Name of School ______________________________________________________________________________

Date Last Enrolled At Least Half Time ___ ___ - ___ ___ - ___ ___ ___ ___

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Borrower Name ________________________________ Borrower SSN: ___ ___ ___ - ___ ___ - ___ ___ ___ ___

SECTION 3: BORROWER CERTIFICATIONS AND AUTHORIZATION

 I certify that: (1) The information I have provided on this form is true and correct. (2) I will provide additional

documentation to my loan holder, as required, to support my deferment status. (3) I will notify my loan holder

immediately when the condition(s) that qualified me for the deferment ends. (4) I have read, understand, and

meet the eligibility requirements and terms and conditions of the deferment(s) for which I have applied, as

explained in Sections 2, 6, and 7.

 I authorize the loan holder to which I submit this request (and its agents or contractors) to contact me regarding my

request or my loan(s), including repayment of my loan(s), at the number that I provide on this form or any future

number that I provide for my cellular telephone or other wireless device using automated telephone dialing

equipment or artificial or prerecorded voice or text messages.

Borrower’s Signature _____________________________________________ Date ___ ___ - ___ ___ - ___ ___ ___ ___

(or Representative’s for Military Service Deferments only)

Representative’s Name (if applicable) _______________________________ Relationship to Borrower _______________

Representative’s Address __________________________________________ Telephone ( _____ ) _____ - ___________

SECTION 4: AUTHORIZED OFFICIAL’S CERTIFICATION

Note: As an alternative to completing this section, the borrower or representative may submit a written statement

from the borrower’s commanding or personnel officer or a copy of the borrower’s military orders. The statement or

copy must include all information needed to establish the borrower’s eligibility for the requested deferment(s),

including the period of the qualifying service. If the borrower is/was serving in an area of hostilities in which service

qualifies for special pay under 37 USC 310, the statement or copy must identify the hostile fire/imminent danger pay

area in which the borrower is/was on active duty.

I certify, to the best of my knowledge and belief, that:

The borrower’s service meets the eligibility requirements for the deferment(s) indicated in Section 2 and as described

in Sections 6 and 7, as applicable.

The borrower’s service begins/began on ___ ___ - ___ ___ - ___ ___ ___ ___ (mm-dd-yyyy)

The borrower’s service ends/ended on ___ ___ - ___ ___ - ___ ___ ___ ___ (mm-dd-yyyy)

 If the borrower is requesting a Military Service Deferment (see Section 2, Item A) 

(1) The borrower is (check one):

A Reserve/retired member called to active duty under 10 USC 12301(a), 12301(g), 12302, 12304, 12306, or 688.

On full-time National Guard duty as defined in 10 USC 101(d)(5) under a call to active duty service authorized by

the President or the Secretary of Defense.

Reassigned to another duty station other than where the member is normally assigned.

Note: If none of the above conditions apply, do not complete this form.

(2) The reassignment/call to active duty/full-time National Guard duty is in connection with the following contingency

operation, national emergency, or war: Operation Enduring Freedom Operation New Dawn

National emergency, war, or other contingency operation (identify) ______________________________________

Note: If the borrower’s service is not in connection with a contingency operation, national emergency, or war, as

defined in Section 6, do not complete this form.

(3) If applicable, by checking this box I further certify that the borrower is/was serving in an area of hostilities in

which service qualifies for special pay under 37 USC 310.

Name of Military Branch or National Guard Component ____________________________________________________

Address ____________________________________________ City, State, Zip Code _____________________________

Name and Title of Authorized Official _______________________________ Telephone ( _____ ) _____ - ____________

Authorized Official’s Signature ______________________________________ Date ___ ___ - ___ ___ - ___ ___ ___ ___

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SECTION 5: INSTRUCTIONS FOR COMPLETING THE FORM

Type or print using dark ink. Enter dates as month-day-year (mm-dd-yyyy). Use only numbers. Example: January 31,

2013 = 01-31-2013. An authorized official must complete Section 4, or a copy of your military orders or a written

statement from your commanding or personnel officer must be attached. Include your name and social security number

on any documentation that you are required to submit with this form. If you need help completing this form, contact

your loan holder. If you are applying for a deferment(s) on loans that are held by different loan holders, you must submit

a separate deferment request to each loan holder.

Return the completed form and any required documentation to the address shown in Section 8.

SECTION 6: DEFINITIONS

 For the Military Service Deferment only--

 Active duty means full-time duty in the active

military service of the United States as defined in 10

USC 101(d)(1), but does not include training or

attendance at a service school.

 Serving on active duty during a war or other

military operation or national emergency means

service by an individual who is (1) a Reserve of an

Armed Force ordered to active duty under 10 USC

12301(a), 12301(g), 12302, 12304, or 12306; (2) a

retired member of an Armed Force ordered to active

duty under 10 USC 688 for service in connection with

a war or other military operation or national

emergency, regardless of the location at which the

active duty service is performed; or (3) any other

member of an Armed Force on active duty in

connection with the emergency or subsequent

actions or conditions who has been assigned to a

duty station at a location other than the location

where the member is normally assigned.

 Military operation means a contingency operation

as defined in 10 USC 101(a)(13). A contingency

operation is a military operation that (1) is

designated by the Secretary of Defense as an

operation in which members of the Armed Forces

are or may become involved in military actions,

operations, or hostilities against an enemy of the

United States or against an opposing military force;

or (2) results in the call or order to, or retention on,

active duty of members of the uniformed services

under 10 USC 688, 12301(a), 12302, 12304, 12305,

or 12406; 10 USC Chapter 15; or any other provision

of law during a war or during a national emergency

declared by the President or Congress.

 National emergency means the national emergency

by reason of certain terrorist attacks declared by the

President on September 14, 2001, or subsequent

national emergencies declared by the President by

reason of terrorist attacks.

 Qualifying National Guard duty during a war or

other operation or national emergency means

training or other duty, other than inactive,

performed by a member of the National Guard on

full-time National Guard duty, as defined in 10 USC

101(d)(5), under a call to active service authorized by

the President or the Secretary of Defense. The

training or other duty must be performed for more

than 30 consecutive days under 32 USC 502(f) in

connection with a war, other military operation, or

national emergency as declared by the President and

supported by federal funds.

 For the Post-Active Duty Student Deferment only--

 For a Reserve or retired member of an Armed Force,

active duty means full-time duty in the active

military service of the United States as defined in 10

USC 101(d)(1) for at least 30 consecutive days of

service, but does not include training or attendance

at a service school.

 For a member of the National Guard, active duty

means (1) active state duty under which a governor

activates National Guard personnel based on state

law or policy and the activities of the National Guard

are paid for with state funds; and (2) full-time

National Guard duty under which a governor is

authorized, with the approval of the President or the

Secretary of Defense, to order a member to state

active duty and the activities of the National Guard

are paid for with federal funds. Active duty for this

deferment does not include (1) active duty for

training or attendance at a service school, or (2)

employment in a full-time, permanent position in

the National Guard unless you are reassigned to

active state duty or full-time National Guard duty as

described in (1) and (2) of the preceding sentence.

 An authorized certifying official who may complete

Section 4 is your commanding or personnel officer.

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 Capitalization is the addition of unpaid interest to the

principal balance of your loan. The principal balance of a

loan increases when payments are postponed during

periods of deferment or forbearance and unpaid

interest is capitalized. As a result, more interest may

accrue over the life of the loan, the monthly payment

amount may be higher, or more payments may be

required. The chart below provides estimates, for a

$15,000 unsubsidized loan balance at a 6.8% interest

rate, of the monthly payments due following a 12-

month deferment that started when the loan entered

repayment. It compares the effects of paying the

interest as it accrues, capitalizing the interest at the end

of the deferment, and capitalizing interest quarterly and

at the end of the deferment. Please note that the U.S.

Department of Education (the Department) and many

other holders do not capitalize interest on a quarterly

basis. The actual loan interest charges will depend on

your interest rate, length of the deferment, and

frequency of capitalization. Paying interest during the

period of deferment lowers the monthly payment by

about $12 and saves about $426 over the lifetime of the

loan, as depicted in the chart below.

Treatment of Interest

Accrued During Deferment

Loan

Amount

Capitalized

Interest for

12 Months

Principal

to Be

Repaid

Monthly

Payment

Number

Payments

Total

Amount

Repaid

Total

Interest

Paid

Interest is paid

$15,000.00

$0.00

$15,000.00

$172.62

120

$21,736.55*

$6,730.66

Interest is capitalized at the

end of deferment

$15,000.00

$1,022.09

$16,022.09

$184.38

120

$22,125.94

$7,119.64

Interest is capitalized

quarterly during deferment

and at the end of

deferment

$15,000.00

$1,048.51

$16,048.51

$184.69

120

$22,162.41

$7,156.10

*Total amount repaid includes $1,022.09 of interest paid during the 12-month period of deferment.

 A deferment is a period during which you are entitled

to postpone repayment of the principal balance of your

loan(s). Interest does not accrue during a deferment on

Perkins Loan Program loans, a Direct Subsidized Loan, a

subsidized Direct Consolidation Loan, a subsidized

Federal Stafford Loan, or, in some cases, the subsidized

portion of a Federal Consolidation Loan (see Note).

Interest does accrue during a deferment on a Direct

Unsubsidized Loan, a Direct PLUS Loan, an unsubsidized

Direct Consolidation Loan, an unsubsidized Federal

Stafford Loan, a Federal PLUS Loan, or a Federal SLS

Loan unless you qualify for the no interest accrual

benefit for active duty service members (see Section 7).

Note: Interest does not accrue on a Federal

Consolidation Loan during a deferment only if: (1) the

application for the Federal Consolidation Loan was

received by your loan holder on or after January 1,

1993, but before August 10, 1993; (2) the application

was received by your loan holder on or after August 10,

1993, and the Federal Consolidation Loan includes only

Federal Stafford Loans that were eligible for federal

interest subsidy; or (3) the application was received by

your loan holder on or after November 13, 1997, in

which case interest does not accrue on the portion of

the Federal Consolidation Loan that paid a subsidized

Direct Loan and/or FFEL Program loan(s).

 The Federal Family Education Loan (FFEL) Program

includes Federal Stafford (Stafford) Loans, Federal PLUS

(PLUS) Loans, Federal Consolidation (Consolidation)

Loans, and Federal Supplemental Loans for Students

(SLS).

 The Federal Perkins Loan (Perkins Loan) Program

includes Federal Perkins Loans, National Direct Student

Loans (NDSL), and National Defense Student Loans

(Defense Loans).

 A forbearance is a period during which you are

permitted to temporarily postpone making payments,

allowed an extension of time for making payments, or

temporarily allowed to make smaller payments than

scheduled.

 The holder of your Direct Loan Program loan(s) is the

Department. The holder of your FFEL Program loan(s)

may be a lender, guaranty agency, secondary market, or

the Department. The holder of your Perkins Loan

Program loan(s) may be a school or the Department.

 The William D. Ford Federal Direct Loan (Direct Loan)

Program 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.

Pa 6 ge 5 of

SECTION 7: ELIGIBILITY REQUIREMENTS AND TERMS/CONDITIONS

 Military Service Deferment eligibility requirements:

You may defer repayment of your loan(s) while you are

(1) serving on active duty during a war or other military

operation or national emergency, or (2) performing

qualifying National Guard duty during a war or other

military operation or national emergency, and for an

additional 180 days following the completion of your

qualifying military service. You must provide your loan

holder with a copy of your military orders or a written

statement from your commanding or personnel officer,

or you must have your commanding or personnel

officer certify in Section 4 on this form.

 Post-Active Duty Student Deferment eligibility

requirements: You may defer repayment of your

loan(s) after your active duty military service and any

applicable grace period until the earlier of (a) the date

you resume enrollment at an eligible school on at least

a half-time basis, or (b) 13 months following the

completion of your active duty military service and any

applicable grace period, if (1) you are a member of the

National Guard or other reserve component of the

Armed Forces or a retired member, and your service

includes a period on or after October 1, 2007; (2) you

were enrolled at least half time at an eligible school

when you were called to active duty or within 6

months before the date you were called to active duty;

(3) you provide your loan holder with the name of the

school you attended and your last date of attendance;

and (4) you provide your loan holder with a copy of

your military orders or a written statement from your

commanding or personnel officer, or your commanding

or personnel officer certifies in Section 4 on this form.

 You are not required to make payments of loan

principal during your deferment. Interest will not

accrue on your Perkins Loan Program loan(s) or on

your subsidized Direct Loan or FFEL Program loan(s)

during your deferment. However, interest will accrue

on your unsubsidized Direct Loan and FFEL Program

loans, unless you qualify for the Direct Loan Program’s

no interest accrual benefit for active duty service

members as explained below.

 You may pay the interest that accrues on your

unsubsidized Direct Loan and FFEL Program loans

during your deferment. Your loan holder may capitalize

interest that you do not pay during the deferment

period on your unsubsidized Direct Loan and FFEL

Program loans.

 If your deferment does not cover all your past due

payments, your loan holder may grant a forbearance

on your loan(s) for all payments due before the begin

date of your deferment. If the period for which you are

eligible for a deferment has ended, your loan holder

may grant a forbearance on your loan(s) for all

payments due when your deferment request is

processed. Interest that accrues during this

forbearance may be capitalized. Unpaid interest that

accrues on a Perkins Loan Program loan during a

forbearance period is not capitalized.

 Your loan holder may grant a forbearance on your

Direct Loan and/or FFEL Program loan(s) for up to 60

days, if necessary, for the collection and processing of

documentation related to your deferment request.

Interest that accrues during this forbearance period

will not be capitalized.

 If you are a Direct Loan borrower, no interest will be

charged on your Direct Loan Program loan(s) that was

first disbursed on or after October 1, 2008, or on the

portion of a Direct Consolidation Loan that repaid a

Direct Loan and/or FFEL Program loan(s) that was first

disbursed on or after October 1, 2008, for a period not

to exceed 60 months while you:

 Qualify for a Military Service Deferment (see Section

2, Item A) as described in Sections 6 and 7, and

 Serve in an area of hostilities in which service

qualifies for special pay under 37 USC 310, as

certified by an authorized official in Section 4, or

documented in a written statement from your

commanding or personnel officer or in a copy of your

military orders.

SECTION 8: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST

Return the completed form and any required

documentation to:

(If no address is shown, return to your loan holder.)

If you need help completing this form, call:

(If no telephone number is shown, call your loan

holder.)

Page 6 of 6

SECTION 9: IMPORTANT NOTICES

Privacy Act Notice. The Privacy Act of 1974 (5 USC 552a)

requires that the following notice be provided to you:

The authority for collecting the requested information

from and about you is §421 et seq., §451 et seq., and/or

§461 et seq. of the Higher Education Act (HEA) of 1965, as

amended (20 USC 1071 et seq., 20 USC 1087a et seq.,

and/or 20 USC 1087aa et seq.), and the authorities for

collecting and using your Social Security Number (SSN) are

§484(a)(4) of the HEA (20 USC 1091(a)(4)) and 31 USC

7701(b). Participating in the Federal Family Education Loan

(FFEL) Program, William D. Ford Federal Direct Loan (Direct

Loan) Program, and Federal Perkins Loan (Perkins) 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 FFEL Program, Direct Loan Program,

and/or Perkins Program, to permit the servicing of your

loan(s), and, if it becomes necessary, to locate you and to

collect and report on your loan(s) if your loan(s) become

delinquent or in 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 loan(s), to enforce the

terms of the loan(s), 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 status, 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

USC 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 it displays a currently

valid OMB control number. Public reporting burden for

this collection of information is estimated to average 0.5

hours (30 minutes) per response, including the time for

reviewing instructions, searching existing data resources,

gathering and maintaining the data needed, and

completing and reviewing the information collection.

Individuals are obligated to respond to this collection to

obtain a benefit in accordance with 34 CFR 674.34,

682.210, or 685.204. Send comments regarding the

burden estimate(s) or any other aspect of this collection of

information, including suggestions for reducing this burden

to the U.S. Department of Education, 400 Maryland

Avenue, SW, Washington, DC 20210-4537 or e-mail

ICDocketMgr@ed.gov and reference OMB Control Number

1845-0080. Note: Please do not return the completed

form to this address.

If you have questions regarding the status of your

individual submission of this form, contact your loan

holder (see Section 8).

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