Fillable Repayment Assistance Plan Application (Alberta Student Aid)

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Repayment Assistance Plan Application (Alberta Student Aid)

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Repayment Assistance Plan Application | Alberta Student Loans Only Last revised March 2020
Repayment Assistance Plan Application
Alberta Student Loan Only
Complete this form if you are only applying for repayment assistance for your Alberta student loan. If you have government-sponsored student loans with
a nancial institution, or you have Canada student loans, complete the application at nslsc.ca.
All elds must be completed. See the instructions on Page 3.
Section 2 - Statement of Monthly Gross Income: You may be required to provide proof of your income.
Gross Family Income during the month you sign and date this application $
Gross Family Income during the month before you sign and date this application $
If you indicated $0 as Gross Family Income for either month (above), tell us how you are meeting your living expenses:
Supported by parent(s)
Supported by other family member
Supported by a friend
Using Personal Savings
Other (please describe): ___________________________________________
Section 3 - Government Student Loan Information
3a) If you have any Alberta student loans, Canada (Full-Time or Part-Time) loans, a Canada Apprentice Loan or a student loan from
another province in repayment, provide the current balance and payment amount below:
Name of Financial Institution or Loan Service Provider Indicate Canada or the Province Current Balance Monthly Payments
$ $
$ $
$ $
$ $
3b) If your spouse/partner has any Alberta student loans, Federal (Full-Time or Part-Time) loans, a Canada Apprentice Loan, or a student
loan from another province in repayment, provide the current balance and payment amount below:
Current balance of student and apprentice loans combined $
Total regular monthly payment of all student and apprentice loan combined $
Section 4 - Applicant’s Signature
By signing below:
• You declare that all information that you have provided in your
Repayment Assistance Plan application, and to any previous Alberta
student loan application, is true and complete, to the best of your
knowledge.
• You acknowledge that in accordance with the provisions of the
Alberta Student Aid agreement, Alberta Student Aid may disclose
and exchange your personal information related to this Application
with other entities, including with any federal, provincial, or territorial
government department or agency, any lending institution where
you
may have a student loan, any consumer credit grantor(s),
credit bureau(s), credit reporting agency(ies), or any person
or business with whom you have or have had nancial dealings
for the purposes of carrying out duties under the Student
Financial Assistance Act (Alberta) and regulations including for
administration, enforcement, debt collection, audit, verication,
research and evaluation purposes. You consent to permit the
direct or indirect collection, retention, use or disclosure of
personal information required by law.
• You understand that if you fail to sign this application, you will
not receive any assistance under the Repayment Assistance Plan.
Section 1 - Applicant Information
Last Name (current legal name)
First Name (current legal name)
Social Insurance Number
Do you have a Permanent Disability?
Yes
No
Marital Status:
Married/Common law
Single
Telephone Number (format: 999-999-9999)
Apt/Box Number
Street Address
City/Town
Prov/State
Email Address
Middle Initial
Family Size:
Country
Postal/Zip Code
Signature of Applicant Application Date
✗ SIGN HERE
Day Month Year
Repayment Assistance Plan Application | Alberta Student Loans Only Last revised March 202
0
Page 2
Repayment Assistance Plan
Eligibility Requirements
1. Your Alberta student loan must be in repayment status. You may be required to provide additional supporting documentation
as proof of all income reported in Section 3 in order to determine eligibility for the Repayment Assistance Plan.
2. If you have outstanding interest that you have not paid, you can choose to add it to your principal (capitalize), if you have
not previously used this option. You may only capitalize up to 3 months of interest to the principal of your loan.
3. You may be restricted from future nancial assistance if you provide false or misleading information, including by omission.
Contact Information: If you need help completing this application or have other questions concerning your student loans, call:
Alberta Student Aid Service Centre
Toll Free in North America: 1-855-606-2096
Toll Free outside of North America: Dial the international access code + 800-2-529-9242
TTY for the Hearing Impaired: 1-855-306-2240
This Repayment Assistance Plan application is for your Alberta student loan only. If you are approved for the Repayment Assistance
Plan, your loan payment terms will be altered during your approved period. Your monthly payment amount will be reduced to an
affordable payment that will never exceed 20% of your gross family income, and may be reduced to a zero payment amount. During
an approved period of the Repayment Assistance Plan, all payments will be applied to your principal rst. If you are not approved,
you will remain responsible for making your regular loan payments in accordance with your payment terms.
Periods of Assistance: The Repayment Assistance Plan is available in 6 month blocks of time (to a maximum of 180 months)
at any point during your loan repayment period.
Re-Application: At the end of your 6 month term, if you wish to continue with the Repayment Assistance Plan, you must re-apply.
If not, you are responsible for making your regular payments in accordance with your payment terms. At the end of your approval
period, you will return to your regular payment schedule, but your amoritzation period may be extended.
Restrictions: If you are approved for the Repayment Assistance Plan, you may be subject to restrictions if you fail to make all your
affordable payments by the end of the month following your 6 month approved period. A restriction will prevent you from obtaining
further loans and grants until you have fully paid your existing student and/or apprentice loans.
Further details on restrictions are available in the Alberta Student Aid Operational Policy Manual on the Student Aid website:
• studentaid.alberta.ca/student-aid-policy
Date and Signature: You must sign and date your application and ensure that Alberta Student Aid receives it within 40 days
of your signature date. You will receive the result of your application electronically in your secure MyLoan account:
• https://myloan.studentaid.alberta.ca
Privacy Notice: Advanced Education is collecting this personal information under the authority of sections 33(a) and (c) of the
Freedom of Information and Protection of Privacy Act (Alberta) to determine and verify your eligibility for financial assistance and
to administer and enforce student financial assistance programs in accordance with the Student Financial Assistance Act
(Alberta), as may be amended from time to time. The use and disclosure of your personal information is managed in accordance
with the Freedom of Information and Protection of Privacy Act (Alberta).
If you have any questions about the collection of this information, call:
Alberta Student Aid Service Centre
Toll Free in North America: 1-855-606-2096
Toll Free outside of North America: Dial the inter
national access code + 800-2-529-9242
TTY for the Hearing Impaired: 1-855-306-2240
Or, mail your questions to:
Alberta Student Aid Service Centre, Executive Customer Assistance Department
PO Box 4050, Mississauga Stn A
Mississauga ON L5A 4M9.
Participation in the Repayment Assistance Plan is voluntary. Refusal to pr
ovide your personal information will make you ineligible
for any assistance under the Repayment Assistance Plan.
Repayment Assistance Plan Application | Alberta Student Loans Only Last revised March 202
0
Page 3
Instructions to Complete your Repayment Assistance Plan Application
To ensure that your Repayment Assistance Application is processed as quickly as possible, it is important that you ll it out completely
and correctly, and provide all supporting documentation.
Section 1 - Applicant Information
Enter your personal information.
Indicate your family size:
Identify the number of people in your family residing with you permanently, including yourself, spouse or common-law partner
and dependants, as applicable. Dependants are children under 21 years of age and living with you or in full-time school
attendance. If you are single, with no dependants, enter “1” for your family size.
Section 2 - Statement of Monthly Gross Income: You may be required to provide proof of your income.
Marital Status:
Single includes: separated, widowed, divorced, single parent and not living common-law.
Spouse means your partner if you are married or common-law.
Indicate if you have a permanent disability:
This information is necessary if you wish to be assessed for the Repayment Assistance Plan for Persons with Permanent Disabilities.
Calculate your monthly gross family income:
Gross family income is before taxes and deductions.
Family Income is you and your spouse’s combined income, if you are married or living common-law.
Examples of income include: employment earnings, investment earnings (cashed in Registered Retirement Savings Plan), payments
received through Federal or Provincial social programs (Employment Insurance, Worker’s Compensation, Canada or Quebec Pension
Plan and superannuation), support payments (child and/or spousal support), monetary gifts or lottery winnings, or other income such
as awards, scholarships, fellowships, bursaries and grants.
The following items are not considered as income: income tax refunds, GST/HST credits, Canada and Alberta child benets,
refundable tax credits (Provincial sales tax, Property Tax Credits, Supplements for Working Families, student loan disbursements).
Deduct the amount of any child support payments or spousal support payments, from your gross monthly income.
Proof of Income:
If you are requested to provide proof of income, please provide photocopies and keep the originals for your les.
If you are self-employed, a monthly business bank statement, a letter from your Financial Institution, or a letter signed by an accountant
is acceptable proof of income.
Section 3 - Government Student Loan Information
Zero Gross Family Income:
If you and, if applicable, your spouse/partner had no income for any of the months on the application, you must describe on the
Repayment Assistance Application how you live or lived on no income.
Information about your and your spouse’s Federal (Full-Time or Part-Time) or Provincial Student Loans and/or Canada
Apprentice Loans that are currently in repayment:
Complete 3a) with your student loan information and if applicable 3b) with your spouse’s student loan information.
These are the details of your student loans (not a student line of credit).
Section 4 - Applicant’s Signature
Sign and date your completed application.
Mail your application and copies of supporting document(s) to the Alberta Student Aid Service Centre.
Alberta Student Aid Service Centre
P.O. Box 4050, Mississauga STN A
Mississauga, ON L5A 4M9
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Completed 23 December 2020

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