| REQUEST FOR DEFERMENT NDSL/PERKINS LOANS |
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| PART 1 - TO BE COMPLETED BY THE BORROWER Refer to second page of document for postponement or partial cancellation |
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| NAME | ACCT. NO. | |||||||||
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| ADDRESS - Check if new ( ) | ||||||||||
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| TELEPHONE NUMBER | LENDING INSTITUTION | |||||||||
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This is to certify that I am/was (CHECK ONE - SEPARATE FORMS MUST BE FILED FOR EACH CATEGORY |
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| ( ) At least a half-time student in an institution of higher education. | ||||||||||
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| ( ) A member of the armed forces on ( ) Active duty ( ) Reserve | ||||||||||
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| ( ) In ( ) Peace Corps ( ) VISTA ( ) ACTION | ||||||||||
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| LOANS MADE AFTER 09/30/80 ONLY | ||||||||||
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| ( ) A full-time volunteer in a tax exempt organization performing service comparable to the Peace Corps or ACTION program | ||||||||||
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| ( ) Serving an internship required prior to professional practice ( ) Resident ( ) Intern (Type ) | ||||||||||
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| ( ) Office in the U.S. Public Health Service Commissioned Corps | ||||||||||
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| ( ) Temporarily totally disabled ( ) Self ( ) Spouse | ||||||||||
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| LOANS MADE AFTER 06/30/87 (PERKINS) | ||||||||||
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| ( ) Mother of a Pre-school Child | ||||||||||
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| ( ) Serving with the National Oceanic and Atmospheric Administration | ||||||||||
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| ( ) Parental Leave ( ) mother ( ) father | ||||||||||
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| ( ) Temporarily totally disabled ( ) dependent | ||||||||||
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| PART 11 - TO BE COMPLETED BY CERTIFYING OFFICIAL I certify that the information in Part 1 is true and correct. |
DATE | |||||||||
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| Signature and title of authorized official (Registrar, Commanding Officer, Certifying Official) | ||||||||||
OFFICIAL SEAL OR STAMP![]() (If not available, provide official letter of Certification) |
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| Name and address of - institution of higher education, institution where receiving advanced professional training, military organization, Peace Corps headquarters, VISTA headquarters, school or employing agency | ||||||||||
| District County |
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| ( ) Public ( ) Private ( ) Not for Profit | ||||||||||
PART 111 - FOR CWU USE ONLY |
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| Partial Cancellation Benefits for Direct/Perkins Student Loans |
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| By performing certain services, which are explained briefly below, you may be eligible for cancellation credit which will reduce both your loan balance as well as the accrued interest on your loan. In order to receive any of these cancellation benefits, you must submit a properly completed "Request for Partial Cancellation" form when entering such service, or upon receiving a bill (whichever comes first), and upon completion of each full year of service. After signing the form, have your school principal, district official, or commanding officer certify the form as required in the appropriate section. Certification must include an official seal or stamp. If no seal or stamp is available include letterhead certification. TEACHING: If you are a full-time teacher in an elementary or secondary school determined by the federal government to have a high concentration of students from low-income families, you may be eligible for a partial cancellation. The list of qualifying schools is published annually by the federal government in the Department of Education Listing of Low-Income Schools. To qualify for cancellation benefits in this category, you must be employed as a full-time teacher for a complete academic year or its equivalent. For the purposes of this category, a teacher is defined as being a person who is a professional employee of a school, or school system, who is devoted to providing classroom instruction, or performing related duties in support of the education program. If you are a full-time teacher of handicapped children in a secondary or elementary school, you my also be eligible for a partial loan cancellation. Handicapped children, as defined by the Direct/Perkins loan program, includes those who are mentally retarded, hard of hearing, deaf, speech impaired, visually handicapped, seriously emotionally disturbed, orthopedically impaired, or other health-impaired children, who by reason thereof, require special education and related services. Beginning with the 1980-81 academic year, this definition of handicapped children was expanded to include children with specific learning disabilities. However, the teaching of children with specific learning disabilities performed prior to the 1980-81 academic year, does not qualify for cancellation as teaching of handicapped children. If you are eligible, your loan will be cancelled at these percentage rates: 15% for the first year of teaching If you teach in the Headstart Program, you may cancel each year at the 15% rate until the entire loan is cancelled.
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