Unemployment Deferment Request
ACCOUNT NUMBER:
ADDRESS:
CITY: ZIP:
TELEPHONE NUMBER:
ALTERNATE TELEPHONE NUMBER:
EMAIL ADDRESS:
STATE:
BORROWER NAME:
I consent to the lender and any other owner, holder, servicer, guarantor or insurer of my account to contact me about my account via autodialer or
similar device and/or using a prerecorded or artificial voice or message for any 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.
I became unemployed or began working less than 30 hours per week on
Check ONE of the boxes below:
COMPLETE THIS ITEM ONLY IF YOU ARE REQUESTING AN EXTENSION OF AN EXISTING UNEMPLOYMENT DEFERMENT AND YOU ARE
NOT PROVIDING DOCUMENTATION OF YOUR ELIGIBILITY FOR UNEMPLOYMENT BENEFITS.
In the most recent six months, I have made at least 6 diligent attempts to find full-time employment.
I meet the following qualifications for an Unemployment Deferment:
OR
(1) I must be eligible for unemployment benefits. I must provide my loan holder with documentation which includes my name, address, and social
security number, and shows that I am eligible to receive unemployment benefits during the period for which I am requesting the deferment
(2) I must be diligently seeking but unable to find full-time employment in any field or at any salary or responsibility level and I must be registered with
a public or private employment agency if there is one within 50 miles of my current address. School placement offices and "temporary" agencies do
not qualify as public or private employment agencies.
(3) If I am requesting an extension of my current unemployment deferment, and I am not providing documentation of my eligibility for unemployment
benefits, I must certify that I have made at least 6 diligent attempts to find full-time employment in the most recent 6 months.
I will provide additional documentation to my loan holder, as required, to support my deferment status. I will notify my loan holder immediately when
the condition(s) that qualified me for the deferment ends.
I understand this request and all supporting documentation will remain the property of the lender and its agent. The owner reserves the right to obtain
a copy of my credit report. I understand that should my situation, under which I applied for has changed, I must immediately notify AES Graduate and
Professional Services. The above information is true and correct to the best of my knowledge. I understand that misrepresentation may lead to the
denial of my request. I have read and understand and agree to the terms of this request.
Borrower Signature
Date
AES P.O. Box 2461 Harrisburg, PA 17105-2461
Please return completed form to:
Fax:
717-720-2774 or 717-720-3931
I am eligible for unemployment benefits and I have attached documentation of my eligibility for these benefits. The documentation includes my
name, address, social security number, and the effective dates of my eligibility to receive unemployment benefits.
OR
I am diligently seeking but unable to find full-time employment, and I have registered with a public or private employment agency.
OR
I am diligently seeking but unable to find full-time employment, but I have not registered with a public or private employment agency because
there is not one within 50 miles of my current address. NOTE: School placement offices and "temporary" agencies do not qualify as public or
private employment agencies.
