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UNEMPLOYMENT DEFERMENT REQUEST
Federal Family Education Loan Program

OMB No. 1845-0005 Form Approved Exp. Date 01/31/2009

UNEM

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents shall be subject to penalties which may include fines, imprisonment or both, under the U.S. Criminal Code and 20 U.S.C. §1097.

SECTION1: BORROWER IDENTIFICATION
Please enter or correct the following information. SSN Name _________________________________________________________ Address ________________________________________________________ City, State, Zip ___________________________________________________ Telephone - Home ( ) _________________________________________ Telephone - Other ( )_________________________________________ E-mail Address (Optional) __________________________________________

SECTION 2: DEFERMENT REQUEST
Before answering any questions, carefully read the entire form, including the instructions and other information in Sections 4, 5, and 6. n I meet the qualifications stated in Section 6 for an Unemployment Deferment and request that my loan holder defer repayment of my loan(s). To documenteligibility, complete the following: (1) I became unemployed or began working less than 30 hours per week on deferment begins on this date, unless I request my deferment to begin on the following later date: (2) Check ONE of the boxes below: (A) r I am diligently seeking but unable to find full-time employment in the United States (see definitions in Section 5) in any field or at any salary orresponsibility level. I am registered with a public or private employment agency if there is one within 50 miles of my current address. Further, if I am requesting an extension of an existing unemployment deferment, I have made at least six diligent attempts to find full-time employment in the most recent six months. NOTE: School placement offices and “temporary” agencies do not qualify as public orprivate employment agencies. OR (B) r I am eligible for unemployment benefits, and I have attached documentation of my eligibility for these benefits. The documentation 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 deferment. . Except as explained in Section 6, my .

SECTION 3:BORROWER UNDERSTANDINGS AND CERTIFICATIONS
n I understand that (1) I am not required to make payments of loan principal during my deferment. Interest will not be charged on my subsidized loan(s) during my deferment. However, interest will be charged on my unsubsidized loan(s). (2) I have the option of making interest payments on my unsubsidized loan(s) during my deferment. (3) I may choose to makeinterest payments by checking the box below. My loan holder may capitalize interest that I do not pay during the deferment period. r I wish to make interest payments on my unsubsidized loan(s) during my deferment. n I certify that the information I have provided in Sections 1 and 2 above is true and correct, and that I have read, understand, and meet the eligibility criteria and terms andconditions of the deferment for which I have applied, as explained in Section 6. Borrower’s Signature _________________________________________________________________________ Date ______________________________

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SECTION 4: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Report dates as month-day-year (MM-DD-YYYY). For example, ‘January 31, 2006’ = ‘01-31-2006’. If youare qualifying for this deferment by documenting your eligibility for unemployment benefits, attach the documentation to this form. If you need help completing this form, contact your loan holder. Return the completed form and any required documentation to the address shown in Section 7.

SECTION 5: DEFINITIONS
n Capitalization is the addition of unpaid interest to the principal balance of...