in certain situations, you can have your federal student loan forgiven, canceled, or discharged.

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1 Frgiveness, Cancellatin, and Discharge I Federal Student Aid I An CFflCE f ih lul DEPARTMUH cf EO!JCATION PROUD SPONSOR f the AMERICAN Ml ND"' Page 1 f6 Prepare fr Cllege Types f Aid Wh Gets Aid v FAFSA: Apply fr v Aid Repay Yur Lans v in certain situatins, yu can have yur federal student lan frgiven, canceled, r discharged. Find ut ivhether yu qualify due t yur jb, disability, the clsure f yur schl, r ther circumstances. Frgiveness, cancellatin, and discharge f yur lan means that yu are n lnger epected t repay yur lan. When can my federal student lans be frgiven, canceled, r discharged? Hw d I find ut if I qualify and hw d I apply t have my lan frgiven, canceled, r discharged? D I need t make payments while my discharge applicatin is being reviewed? What happens if my Jan discharge is apprved? What happens if my lan discharge is denied? Cmmn Questins l was very yung when I brrwed this mney. D I still have t repay? J signed the Master Prmissry Nte but I didn't attend class. D I stm have t pay? I'm a parent that tk a PLUS Lan t help pay fr my child's educatin. Can my lan ever be frgiven, canceled, r discharged? Q U ick Lin ks Repayment Plans Lan Cnslidatin Deferment and Frbearance Understanding Default When can my federal student lans be frgiven, canceled, r discharged? Yu must repay yur la11s even if yu dn't cn1plete yur educatin, can t find a jb related t yur prgran1 f study, r are unhappy with the educatin yu paid fr "vith yur lan. H\.vever, certain circtunstances n1ight lead t yur lans being frgiven canceled r discharged. The list belw is a quick view f the types f.frgiveness, cancellatin, and discharge. Type f Frgiveness, Cancellatin, r Discharge Direct Lans Federal Family Educatin Lan (FFEL) Prgram Lans Perkins Lans Dischanre in Bankruptcy (in rare cases).ealse Cer:tific.atin f Stgg:pnt Eligibilitv..P.I!I!1 a uthrize_q_efil1n ent Di schar_g1< Unpaid Refi.md Discharge 1/14/2015

2 Frgiveness, Cancellatin, and Discharge I Federal Student Aid Page 2 f6 Glssary Pu_blic Service Lan Frgiverrcss Cancellatin Perkins Lan Cancellatin and Dischaw (includes Teacher Cancellatin) The release f the brr,ver's bligatin t repay all r a designated prtin f principal and interest n a student lan. Als called discharge r frgiveness f a lan. _Lking fr infm1atin abut the Civil Legal Assistance A110111ey Sh1dent Lan Repayn1ent Prgratn (CLAARP)? The CLAARP alicatin prcess is clsed. Discharge The release f a brrvver frm the bligatin t repay his r her T vie\v charts f discharges by lan type as \Vell as discharge applicatins, g t Frgiveness, Cancc11atin. and Discharge Charts. Federal Family Educatin Lan (FFEL) Prgram Under this prgrajn, private lenders prvided lans t students that \Vere guaranteed by the federal gvernment. These lans included Subsidized Federal Staffrd Lans, Unsubsidized Federal Staffrd.. Ttal and Permanent Disability (TPD) Discharge William D. Frd Federal Direct Lan (Direct Lan) Prgram A TPD discharge relieves yu frm having t repay a \Villiam D, Frd 'Federal Direct Lan (Direct Lan) Prgram lan, Federal Family Educatin Lan (FFEL) Prgrain lan, and/r Federal Perkins Lan (Perkins Lan) Prgran1 lan r cmplete a TEACH Grant servke bligatin n the basis f yur ttal and permanent disability. Befre yur federal student lans r TEACH Grant service bligatin can be discharged, yu must prvide infrmatin t the U.S. Department f Educatin (ED) t sh\v that yu are ttally and permanently disabled. ED \Vilt evaluate the infnnatin and detennine if yu qua.iii) fr a TPD discharge. Yu can shv.' that yu are ttally and pennanently disabled in ne f the fllwing three \Vays: 1. If yu urea veteran, yu can submit dcumentatin frm the U.S. Department f Veterans Affairs (VA) sh\ving that the VA bas detem1ined that yu are unemplyable due t a service-cnnected disability. 2, lfyu are receiving Scial Security Disability Insurance (SSDI) r Suppleinental Security Incme (SSI) benefits, yu can submit a Scial Security AdJ.ninistratin (SSA) ntice f mvard fr SSDI r SSI benefits stating that yur net scheduled disability review \Vill be v.1.thin five t seven years frn1 the date f yur 1nst recent SSA disability detern1inatin. 3. Yu c311 submit certificatin frm a physician that yu are ttally 311d pem1anently disabled. Yur physician n1ust certify that yu are unable t engage in any substantial gainful activity by reasn f a n1edically detenninable physical r 1nental impairment that The tederal prgrmn that prvides lajls t eligible student and parent b1to"\vers under Title N f the Higher Educatin Act. Funds arc prvided by the federal gvcnnnent t eligible brr,vers... Direct Lan A federal student lan, made thrugh the \\lilliam D. Frd Federal Direct Lan Prgrmn, fr vl'lllch eligible students and parents brrv..' directly fr111 the U.S. Department f Educatin at participating. Federal Perkins Lan A federal student lan made by the recipient's schl fr undergraduate and graduate students wh de1nnstrate financial need. Can be epected t result in death, Has lasted fr a cntinuus perid f nt less than 601nnths, r Can be epected t last fr a cntinuus perid f nt less than 60 mnths. Fr mre infnnatin, g t Ttaj andefil!l1anent Disability Discharfil:. Death Discharge If yu, U1e brrv.'er, die, then yur federal student lans will be discharged If yu are a p31 ent PLUS lan brrvver, then the lan may be discharged if yu die. r if the student n whse behalf yu btained the lan dies. Financial aid, ften based n financial need, that des nt need t be repaid (unless, tor ean1ple, yu -..vithdraw fr1n schl and 've a refund). Service Obligatin The teaching service require111ent set ut in the Agrcc1nent t Serve (ATS) that yu 1nust sign t receive a TEACH Grant By signing the ATS_, yu agree t teach (I) fulltime, (2) in a high~nced f /14/2015

3 Frgiveness, Cancellatin, and Discharge I Federal Student Aid The lan will be discharged if a fainily n1en1ber r ther representative prvides a certified cpy f the death certificate t the schl (fr a Federal Perkins Lan_) r t the lan servicer (fr a Direct Lan r FFEL Prgram lan). Fr 1nre infnnatin, cntact yur lan servicer. Discharge in Bankruptcy Page 3 f6 Lan Servicer A cmpany that cllects payments, respnds t custmer service inquiries, and perfnns ther administrative tasks assciated \.\ith maintaining a federal student Jan n behalf f a lender. If y.. This is nt an aut1natic prcess-yu n1ust prve t the bankruptcy clrri that repaying yur student lan vuld cause undue hardship. Jf yu file Chapt~r 7 r Chapter 11 bankn1ptcy, yu intly have yur lan discharged in bankruptcy nly if the bankruptcy curt finds that repayn1ent vvuld in1pse undue hardship n yu and yur dependents. This must be decided in an adversary prceeding in bankruptcy curt. Yur creditrs 1nay be present t challenge the request. "111e curt uses this three-part test t determine hardship: If yu are frced t repay the lm1, yu -.,vuld nt be able t maintain a miuin1al standard f living. There is evidence that this hardship will cntinue fr a significant prtin f the lan repayn1ent perid. FFEL Prgram Federal Family Educatin Lan Prgran1 Federal Student Aid Financial aid :fr1n the tederal gvcrmnent t help yu pay fr educatin epenses at an eligible cllege r career schl. Grants, lans and "\Vrk-stndy are types f federal student aid Yu must cm... Yu made gd-faith effrts t repay the lan befre filing bankruptcy (usually Uris n1eans yu have been in repayment tor a minitnum f five years). Yur lan \vi.11 nt be discharged if yu are unable t satisfy any ne f the three require1nents. If yur lan is discharged, yu will nt have t repay any prtin f yur lan, and all clleclin activity will &ip. Yu als v.'ill regain eli!iibility fr federal student aid if yu had previusly lst it False Certificatin f Student Eligibility r Unauthrized Payment Discharge Yu 1nay be eligible ±Or a discharge f yur Direct Lan r FFEL Prgram lan in these circumstances: Yur schl falsely certified yur eligibility 10 receive the lan based n yur ability t benefit frm its training, and yu did nt n1eet the ability t benefit student eligibility require1nents. The schl signed yur nan1e n the applicatin r pr1nissry nte \Nithut yur authrizatin r the schl endrsed yur lan check r signed yur authrizatin fr electrnic funds transfer "rithut yur kn-.,vlcdge, unless the prceeds f the lan '>'.:ere delivered t yu r applied t charges wed by yu t the schl. Yur lan -.,vas falsely certified because yu '\\'ere a victlln f identity theft. The schl certified yur eligibility, but because f a physical r mental cnditin, age, criminal recrd, r ther reasn yu are disqualified frm emplyment in the ccupatin in 'lvhich yu were being trained. Unpaid Refund Discharge Yu n1ay be eligible fr a discharge f yur Direct Lan r FFEL Prgram lan if yu \Nithdre-.,v frn1 schl, but the schl didn't pay a refwld that it vved t the U.S. Department f Educatin r t the lender, as apprpriate. Check \-vitb the schl t see h-.,v refund plicies apply t federal aid at the schl. The rganizatin that made the lan initially; the lender culd be the brr-.,ver's schl; a bank, credit unin, r ther lending institutin; r the U.S. Dcpartlnent f Educatin. New Brrwer Smene v.'h has n utstanding balance n a Direct Lan r Federal Family Educatin Lan (FFEL) Prgram lan,,.,:hen he r she receives a Direct Lan r FFEL Prgrmn lan n r after a specific date.<.. Educatinal Service Agency An educatinal service agency is a reginal public multiservice agency (nt a private rganizatin) that is authrized by state law t develp, n1anage, and prvide services.. Failure t repay a lan accrding t the tem1s agreed t in the prn1issry nte. Fr n1st federal student lans, yu will default if yu have nt made a paym.ent in n1re than 270 days. Yu may. Only the an1unt f the unpaid refund will be discharged. Yu may qualify fr this partial discharge v :hether the schl is clsed r pen. Cntact yur lan servicer fr mre infrmatin. Teacher Lan Frgiveness A lm1 epense charged ior the use fbrr\ved mney. Interest is paid by a brr\ver t a lender. Tbe e}.-pense is calculated as a percentage f the unpaid principal an101u1t f the lan. Subsidized Lan lf yu are a teacher m1d als a ne\v brr1ver (i.e., yu did nt have m1 utstanding balm1ce n a Direct Lan r FFEL Prgrmn lan n Oct. 1, 1998, r n the date yu btained a Direct Lan r FFEL Prgran1 lan after Oct. 1/14/2015

4 Frgiveness, Cancellatin, and Discharge I Federal Student Aid 1, 1998) and have been teaching full-tin1e in a lvv-incme elen1entary r secndary schl r educatinal service agency fr five cnsecutive years, yu may be able t have as n1uch as $17,500 f yur subsidized r unsubsidized lans frgiven. Yur PLUS lans cannt be included. Fr mre infm1atin, g t Teacher Lan Frgiveness. If yu have a Federal Perkins Lan, see Perkins Lan Cancellati11 fr teacher cancellatin in that lan prgram. Public Service Lan Frgiveness ~f u are ~n_lp1()_yed_ in cef!:all1 public scn~i~e jbs and have.mad~ 120 pa)~1ents n yur Di_~ect Lans (after Oct 1, 2007), the remaining balance that yu we may be frgiven. Only payments made truder certain repayment plans tnay be cunted tward the required 120 payments. Yu 1nust nt be :in default n the lans that are frgiven. Fr n1re infm1atin, g t Public Service Lan Frgiveness. Page 4 f6 A lan based n financial need fr \.Vhich the federal gvernn1cnt pays the interest that accn1es \Vhilc the brr" er is in an in-schl, grace, r defennent status. Fr Direct Subsidized Lans fi.. Unsubsidized Lan A lan fr 'vhich the brrv.'er is fully respnsible fr paying the interest regardless f the lan status. Interest n unsubsidized lans accrues fr1n the date f disburse1nent and cntinues.tp..rugh.. Perkins Lan Cancellatin and Discharge The fllvl'ing Federal Perkins Lan Prgrrun cancellatins apply t individuals wh perfnn certain types f public service r arc en1plyed in certain ccupatins. Fr each c1nplete year f service, a percentage f the lan may be canceled. The ttal percentage f the lan that can be canceled depends n the type f service perfrmed. Depending n the type f lan yu have, and \'>'hen that lan \vas taken ut, yu n1ay be eligible t cancel part f r yur entire lan if yu have served as ne f the fllviing: Vlunteer in the Peace Crps r ACTION prgran1 (including VISTA) Men1ber f the U.S. armed frces (serving in area f hstilities) Nurse r medical technician Law enfrce1nent r crrectins fficer Head Start wrker Child r fan1ily services \Vrker Prfessinal prvider f early interventin services There is n standard applicatin frm fr Perkins Lan cancellatins. Cntact the schl that yu \Vere attending c ived the lat1.. View the Perkins Lan Cancellatin and Discharge Sum1narv Chart. Hw d I find ut if I qualify and hw d I apply t have my lan frgiven, canceled, r discharged? After revie;viug the cnditins, if yu think yu quali.j}', cntact yur lan servicer. If yu have a Federal Perkins l,an, yu n1ust apply t the schl t11at n1ade the lan r cntact the lan servicer the schl has designated. Certain types f cancellatins are available t n1ilitary persnnel, teachers, nurses, child care prviders, r brrwers affected by the clsure f a schl. Prvisins differ depending n the type f lan yu have. Yu can vievi' yur lan infnnatin including the types f lans yu have and yur lan servicer by lgging in t M federal St_u dent AjQ. 1/14/2015

5 Frgiveness, Cancellatin, and Discharge I Federal Student Aid Page 5 f6 D I need t make payments while my discharge applicatin is being reviewed? Y cs. Until yu hear \Ovhether yur discharge has been apprved, yu shuld cntinue making payn1ents n yur lan t prevent it fr1n ging int default r accruing (accumulating) additinal int"erest. Hwever, nte the fll\ving: If yu have a Direct Subsidized Lan, Direct ltnsubsidized Lan, Federal Subsidized Staffrd Lan, r Federal ljnsubsidized Statird Lan, yu can be granted frbearance. Yur lan servicer shuld grant f\.)rbcarance until a decisin is made n yur applicatin. If frbearance is granted, n ne is pennitted t cllect n yur lan until it is detennined whetl1er yu are eligible fr a lan discharge. If yu have a Federal Perklns Lan.. schls aut1natically defer yur lans if yu are perfrmij1g service (such as teaching in a lvv~incme schl) that \Vill qualify yu fr lan cancellatin. Check \.Vith yur schl fr details. What happens if my lan discharge is apprved? If yu qualify fr a cmplete discharge f yur lan, yu are n lnger bligated t n1ake lan payments. Depending n the type f lan discharge prgram fbr \vhich yu may be eligible, the U.S. Departn1ent f Educatin may be required t refund t yu sn1e r all f the payn1ents yu 1nade n the lan. In additin, any adverse credit recrd related t a default might be deleted, and n ta refund ffset r \Yage gan1ishment \vill take. place t cllect n the discharged lan. If the lan was in default, the discharge 1nay erase the default status. If yu have n ther defaulted lans, yu regain eligibility fr federal student aid. Nte: In sn1e cases, yur schl n1ight be required t refund a prtin f a Direct Lan r FFEL Prgram lan t tbe U.S. Departn1ent f Educatin (fr eample, yu \Vithdrevv frn1 schl witbi.u a timeframe that required a refund f lan funds). If yur schl fails t make tbat refund, that prtin f yur lan will be canceled, but yu \Vill be respnsible fr paying any remaining ainunt. What happens if my lan discharge is denied? Fr mst discharges, the final decisin n whether t discharge the lan cannt be appealed. The tw eceptins are false certificatin and frged signature discharges. If yu receive these types f discharges, yu may ask the U.S. Department f Educatin t revievv the denial. _Tf yur lan discharge is denied, yu remain respnsible fr repaying the lan. Talk t yur lan servicer abut repayment ptins if yu have a Direct Lan r FFEL Prgram lan. Check ut repayment ptins. If yur lan is in default, g t ljnderstanding Default fr mre infnnatin. If yur schl has clsed, yu shuld als eplre the follwing ptins if yur discharge applicatin is denied; Cntact the state licensing agency and ask if there is a tuitin recvery fund r perfrmance bnd that \vill cver yur dan1ages based n the schl clsure. Tf the schl filed bankruptcy, yu shuld file a claim fr yur lss in the bankruptcy prceeding. Yu als nligbt \vant t cnsult an attrney abut any ptins yu 111ay have thrugh the curt system. 1/14/2015

6 Frgiveness, Cancellatin, and Discharge I Federal Student Aid Page 6 f6 Cmmn Questins The fll\:vti1g are sme cnunn questins abut lan frgiveness, cancellatin._ r discharge. I was very yung when I brrwed this mney. D I still have t pay? Yes. T]Jc fact that yu did..ri't. fully understand the imp1icatins f getting a lan, r the fact that it's been many years since yu signed tor the lan, des nt n1ean that yu d nt have t pay. I signed the Master Prmissry Nte but I didn't attend class. D I still have t pay? lf yu received the prceeds f a lan but never attended classes, yu are bligated t return the funds i1nmediately. Yur schl \vill return any funds that it received and applied t yur accunt. If yu d nt return the funds that yu directly received, yur lan will be placed in default I'm a parent that tk a PLUS lan t help pay fr my child's educatin. Can my lan ever be frgiven, canceled, r discharged? Yu 1nust repay yur parent PL US lan even if the student desn t cmplete his r her educatin r can't find a jb related t the prgram f study, r if yu r the student is unhappy >vith the educatin. H\vever, the lan njay be discharged if the child fr \vhm yu brr\ved dies, r if yu die r bec1ne ttally and permanently disabled. \Ve rr1ay discharge sn1e r all f yur lan in any f these circumstances: The schl clsed befre the student cmpleted the prgran1. The schl frged the signature n yur prn1issry nte r falsely certified that yu \Vere eligible fr aid. The lan \Vas falsely certified thrugh identity theft. The student \Vithdrew frn1 schl but the schl didn't pay a refund that it O\ved. Check \Vith the schl t see h\v refund plicies apply t federal aid at the schl. The lan vvas discharged in bankruptcy clain1. This is nt an autmatic prcess -yu must prve t the bankruptcy curt that repaying the lan wuld cause w1due hardship. Cntact yur lan servicer fr mre infrmatin. If yu dn't kn'v wh yur Jan servicer is, visit My Federal ~tudent Aid /2015

7 ,, TEACHER LOAN FORGIVENESS APPLICATION $ ~ William D. Frd Federal Direct Lan (Direct Lan) Prgram ~.,,,., 0,;;e Federal Family Educatin Lan (FFEL) Prgram OMB N Frm Apprved Ep. Date 07 /31/2017 TLFA WARNING: Any persn wh knwingly makes a false statement r misrepresentatin n this frm r n any accmpanying dcument is subject t penalties that may include fines, imprisnment, r bth, under the U.S. Criminal Cde and 20 U.S.C SECTION 1: BORROWER IDENTIFICATION Please enter r crrect the fllwing infrmatin. D Check this b if any f yur infrmatin has changed. SSN Name Address City, State, Zip Cde Telephne- Primary Telephne -Alternate (ptinal) SECTION 2: LOAN FORGIVENESS REQUEST (TO BE COMPLETED BY THE BORROWER) READ SECTIONS 7-10 BEFORE COMPLETING THE FORM. The infrmatin yu prvide is subject t verificatin. I request frgiveness n my Direct Lan and/r FFEL prgram lan(s) based n my emplyment as a full-time teacher fr at least five cnsecutive, cmplete academic years. During the perid that qualifies me fr lan frgiveness, I taught (check all that apply): D at an eligible elementary schl D at an eligible secndary schl D fr an eligible educatinal service agency AND I was (check all that apply): DA highly qualified full-time special educatin teacher fr elementary schl children with disabilities. The children's disabilities crrespnded t my special educatin training, and I demnstrated knwledge and teaching skills in the cntent areas f the elementary schl curriculum (frgiveness f up t $17,500). D A bigbly qualified full-time special educatin teacher fr secndary 5chl cbjldrpn \Mith disahiljties The cbildrpn's disabilities crrespnded t my special educatin training, and I demnstrated knwledge and teaching skills in the cntent areas f the secndary schl curriculum (frgiveness f up t $17,500}. DA highly qualified full-time mathematics teacher fr secndary schl students (frgiveness f up t $17,500}. DA highly qualified full-time science teacher fr secndary schl students (frgiveness f up t $17,500). DA full-time secndary educatin teacher in a subject area relevant t my academic majr (nly if my teaching service began befre 10/30/2004), r a highly qualified full-time secndary educatin teacher (frgiveness f up t $5,000}. DA full-time elementary educatin teacher and I demnstrated knwledge and teaching skills in reading, writing, mathematics, and ther areas f the elementary schl curriculum (nly if my teaching service began befre 10/30/2004), r a highly qualified full-time elementary educatin teacher (frgiveness f up t $5,000}. Cntinued n the net page. Page 1 f8

8 Brrwer's Name Brrwer's SSN SECTION 3: PREVIOUS LOAN FORGIVENESS INFORMATION (TO BE COMPLETED BY THE BORROWER) Check ne f the bes belw: DI have nt previusly applied fr r received lan frgiveness under this Teacher Lan Frgiveness Prgram. DI have applied fr r received lan frgiveness under this Teacher Lan Frgiveness Prgram with the lan hlder listed belw. (If yu check this b, prvide the lan hlder and frgiveness amunt infrmatin requested belw. If yu have applied fr but have nt yet received frgiveness, leave "Frgiveness Amunt" blank.) Lan Hlder Name Telephne r Web Site Frgiveness Amunt$ SECTION 4: UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION (TO BE COMPLETED BY THE BORROWER) I understand that: (1) a frbearance f principal and accrued interest will be applied n the qualifying lan(s) frm the date my lan hlder receives my cmpleted lan frgiveness applicatin thrugh the date the lan frgiveness request is apprved r denied, unless I ntify my lan hlder that I intend t make regular payments during this perid; (2) making regular payments may reduce the amunt f my lan frgiveness; (3) if I am past due n payments when this applicatin is prcessed, my lan hlder may grant a separate frbearance t reslve the delinquency n these payments; and (4) any unpaid interest that accrues during each f these frbearance perids may be capitalized. I certify that: (1) the infrmatin I prvided in Sectins 1-3 is true and crrect; and (2) I have read and understand the definitins and terms and cnditins in Sectins 8-10, and I meet the eligibility requirements fr lan frgiveness. I authrize the lan hlder t which I submit this request (and its agents r cntractrs) t cntact me regarding my request r my lan(s), including repayment f my lan(s), at the number that I prvide n this frm r any future number that I prvide fr my cellular telephne r ther wireless device using autmated telephne dialing equipment r artificial r prerecrded vice r tet messages. Brrwer's Signature Tday's Date - - SECTION 5: CHIEF ADMINISTRATIVE OFFICER'S CERTIFICATION TO BE COMPLETED BY THE CHIEF ADMINISTRATIVE OFFICER - SEE DEFINITION IN SECTION 8. Befre cmpleting this sectin, carefully read Sectins Mre than ne chief administrative fficer's certificatin may be required. Return the cmpleted frm t the applicant identified in Sectin 1. I certify, t the best f my knwledge and belief, that: (1) the applicant has met the requirements fr lan frgiveness as specified in Sectins 8-10, and (2) during the perid fr which the applicant is seeking frgiveness, the applicant was a teacher as defined in Sectins 8 and 9 and taught full time fr cnsecutive, cmplete academic year(s) at ne r mre eligible Title I schls r educatinal service agencies (ESAs) in the capacity that the applicant has indicated in Sectin 2 frm(mm-dd-yyyy) - - t - -. Schl (nt schl district) r ESA Name Check here if this is a schl perated by the Bureau f Indian Educatin (BIE) r perated n an Indian reservatin by an Indian tribal grup under cntract with the BIE. Schl r ESA Address (Street, City, State, Zip Cde) Schl District Cunty Chief Administrative Officer's Name and Title (Printed) Chief Administrative Officer's Signature Telephne ( (ptinal) Tday's Date (mm-dd-yyyy) - - Page 2f8

9 SECTION 6: WHERE TO SEND THE COMPLETED TEACHER LOAN FORGIVENESS APPLICATION Return the cmpleted frm and any required dcumentatin t: If yu need help cmpleting this frm, call: (If n address is shwn, return t yur lan hlder.) (If n infrmatin is shwn, cntact yur lan hlder.) SECTION 7: GENERAL INFORMATION AND INSTRUCTIONS FOR COMPLETING THE FORM The Teacher Lan Frgiveness Prgram is intended t encurage individuals t enter and cntinue in the teaching prfessin. Under this prgram, if yu teach full time fr five cnsecutive, cmplete academic years at certain elementary and secndary schls r fr certain educatinal service agencies that serve lw-incme families and meet ther qualificatins, yu may be eligible fr frgiveness f up t a cmbined ttal f $17,500 in principal and interest n yur Direct Lan and/r FFEL prgram lans. Fr cmplete eligibility requirements, see Sectins Thrughut this frm, all references t "the Department" mean the U.S. Department f Educatin. Befre cmpleting Sectins 2-4, carefully read the entire frm. Be sure t prvide all requested infrmatin. Enter yur name and Scial Security Number at the f page 2. Type r print using dark ink. Shw dates as mm-dd-yyyy (fr eample, shw "January 31, 2014" as " "). The chief administrative fficer f the schl r educatinal service agency where yu perfrmed yur qualifying teaching service must cmplete Sectin 5. If yu taught at mre than ne schl r fr mre than ne educatinal service agency during the same academic year, the chief administrative fficer frm ne f the schls r educatinal service agencies may cmplete Sectin 5. Hwever, all f the schls and/r educatinal service agencies must be listed. If yu taught at different schls rfr different educatinal service agencies during different academic years, the chief administrative fficers frm all f the schls r educatinal service agencies must certify yur eligibility. If yu need mre than ne chief administrative fficer's certificatin, the additinal certificatins, cntaining the infrmatin in Sectin 5, may be prvided n a separate piece f paper and submitted with yur cmpleted frm. Return the cmpleted frm t the address shwn in Sectin 6. If yu are applying fr frgiveness f lans that are held by different lan hlders, yu must submit a separate frm t each lan hlder. SECTION 8: DEFINITIONS A teacher is a persn wh prvides direct classrm teaching r classrm-type teaching in a nn-classrm setting, including special educatin teachers (see belw). NOTE: Schl librarians, guidance cunselrs, and ther administrative staff are nt cnsidered teachers fr the purpses f this lan frgiveness prgram. Special educatin means specially designed instructin, at n cst t parents, t meet the unique needs f a child with a disability (see belw), including i~structin cnducted in the classrm, in the hme, in hspitals and institutins, and in ther settings; and instructin in physical educatin (see belw). A child with a disability is a child wh needs special educatin and related services because the child has an intellectual disability, a hearing impairment (including deafness), a speech r language impairment, a visual impairment (including blindness), a serius emtinal disturbance, an rthpedic impairment, autism, a traumatic brain injury, anther health impairment, r a specific learning disability. Fr a child age 3 thrugh 9, the term "a child with a disability" may, at the discretin f the state and the lcal educatinal agency, include a child wh needs special educatin and related services because the child is eperiencing develpmental delays, as defined by the state and as measured by apprpriate diagnstic instruments and prcedures, in ne r mre f the fllwing areas: physical develpment, cgnitive develpment, cmmunicatin develpment, scial r emtinal develpment, r adaptive develpment. Page 3 f8

10 SECTION 8: DEFINITIONS (CONTINUED) Physical educatin means the develpment f physical and mtr fitness, fundamental mtr skills and patterns, and skills in aquatics, dance, and individual and grup games and sprts (including intramural and lifetime sprts), and includes special physical educatin, adapted physical educatin, mvement educatin, and mtr develpment. An elementary schl is a public r nnprfit private schl that prvides elementary educatin as determined by state law r, if the schl is nt in a state, by the Department. A secndary schl is a public r nnprfit private schl that prvides secndary educatin as determined by state law r, if the schl is nt in a state, by the Department. An educatinal service agency is a reginal public multiservice agency (nt a private rganizatin) authrized by state statute t develp, manage, and prvide services r prgrams t lcal educatinal agencies (such as public schl districts), as defined in sectin 9101 f the Elementary and Secndary Educatin Act f 1965, as amended. An academic year is: One cmplete schl year at the same schl r fr the same educatinal service agency, r Tw cmplete and cnsecutive half years at different schls r fr different educatinal service agencies, r Tw cmplete and cnsecutive half years frm different schl years at either the same schl r fr the same educatinal service agency r at different schls r fr different educatinal service agencies. Half years d nt include summer sessins. Tw half years generally fall within a 12-mnth perid. Fr schls r educatinal service agencies that have a year-rund prgram f instructin, a minimum f nine mnths is cnsidered an academic year. Full time means the standard used by a state in defining full-time emplyment as a teacher. If yu teach in mre than ne schl r educatinal service agency, full time is based n the cmbinatin f all f yur qualifying emplyment. Lans that are eligible fr frgiveness are Federal Direct Staffrd/Frd Lans (Direct Subsidized Lans), Federal Direct Unsubsidized Staffrd/Frd Lans (Direct Unsubsidized Lans), Subsidized Federal Staffrd Lans, Unsubsidized Federal Staffrd Lans, and any prtin f a Federal Direct Cnslidatin Lan r Federal Cnslidatin Lan that paid ff an eligible Direct Subsidized Lan, Direct Unsubsidized Lan, Subsidized Federal Staffrd Lan, r Unsubsidized Federal Staffrd Lan. Direct PLUS Lans, Federal PLUS Lans, and any prtin f a Direct Cnslidatin Lan r Federal Cnslidatin Lan that repaid a PLUS lan are nt eligible fr frgiveness. The hlder f yur Direct Lan Prgram lans is the Department. The hlder f yur FFEL Prgram lans may be a lender, secndary market, guaranty agency, r the Department. Yur lan hlder may use a servicer t handle billing and ther cmmunicatins related t yur lans. References t "yur lan hlder" n this frm mean either yur The chief administrative fficer is the fficial wh has access t emplyment recrds that establish yur eligibility fr lan frgiveness in accrdance with the requirements eplained n this frm, and wh is authrized t verify yur qualifying emplyment at a schl r by an educatinal service agency. Depending n yur emplyer, the chief administrative fficer may be a superintendent, a human resurces fficial r ther schl district r educatinal service agency fficial, r a principal r assistant principal. A frbearance is a temprary cessatin f payments, an etensin f time fr making payments, r temprary acceptance f smaller payments than previusly scheduled. Yu are respnsible fr any interest that accrues n a lan during frbearance. If yu d nt pay the interest that accrues n the lan, the interest may be capitalized. Capitalizatin is the additin f unpaid interest t the principal balance f yur lan. This will increase the principal and ttal cst f yur lan. Page 4 f 8

11 SECTION 9: DEFINITION OF HIGHLY QUALIFIED PUBLIC SCHOOL TEACHERS (INCLUDING TEACHERS EMPLOYED BY EDUCATIONAL SERVICE AGENCIES) T be a highly qualified teacher, a teacher f public elementary r secndary schl students must: Have btained full state certificatin as a teacher (including certificatin btained thrugh alternative rutes t certificatin) r passed the state teacher licensing eaminatin, and hld a license t teach in that state, ecept that when used with respect t teaching in a public charter schl, the term "highly qualified teacher" means that the teacher meets the requirements set frth in the state's public charter schl law; and Nt have had certificatin r licensure requirements waived n an emergency, temprary, r prvisinal basis. lnca8clftin - -- A teacher f elementary schl students wh is new t the prfessin als is cnsidered highly qualified if the teacher: Hlds at least a bachelr's degree; and Has demnstrated, by passing a rigrus state test, subject knwledge and teaching skills in reading, writing, mathematics, and ther areas f the basic elementary schl curriculum (which may cnsist f passing a staterequired certificatin r licensing test r tests in reading, writing, mathematics, and ther areas f the basic elementary schl curriculum). A teacher f middle r secndary schl students wh is new t the prfessin als is cnsidered highly qualified if the teacher: Hlds at least a bachelr's degree; and Has demnstrated a high level f cmpetency in each f the academic subjects in which the teacher teaches by: Passing a rigrus state academic subject test in each f the academic subjects in which the teacher teaches (which may cnsist f a passing level f perfrmance n a state-required certificatin r licensing test r tests in each f the academic subjects in which the teacher teaches); r Successful cmpletin, in each f the academic subjects in which the teacher teaches, f an academic majr, a graduate degree, cursewrk equivalent t an undergraduate academic majr, r advanced certificatin r credentialing. A teacher f elementary, middle, r secndary schl students wh is nt new t the prfessin als is cnsidered highly qualified ifthe teacher hlds at least a bachelr's degree and: Meets the applicable standards f a teacher f elementary, middle, r secndary schl students wh is new t the prfessin; r Demnstrates cmpetence in all the academic subjects in which the teacher teaches based n a high bjective, unifrm state standard f evaluatin that: Is set by tl1e state f1 btl 1 g1 ade app1 p1 iate aeade111ie stjbjeet rnatter k11av11 ledge afld teaehiflg skills, Is aligned with challenging state academic cntent and student academic achievement standards and develped in cnsultatin with cre cntent specialists, teachers, principals, and schl administratrs; Prvides bjective, cherent infrmatin abut the teacher's attainment f cre cntent knwledge in the academic subjects in which a teacher teaches; Is applied unifrmly t all teachers in the same academic subject and the same grade level thrughut the state; Takes int cnsideratin, but is nt based primarily n, the time the teacher has been teaching in the academic subject; Is made available t the public upn request; and May invlve multiple, bjective measures f teacher cmpetency. PRIVATE SCHOOL TEACHERS T be a highly qualified teacher, a teacher in a private, nn-prfit elementary r secndary schl wh is nt a highly qualified teacher as defined abve must be permitted t and satisfy rigrus subject knwledge and skills tests by taking Page 5 f8

12 SECTION 9: DEFINITION OF HIGHLY QUALIFIED {CONTINUED) cmpetency tests in applicable grade levels and subject areas. The cmpetency tests must be recgnized by five r mre states fr the purpses ffulfilling the highly qualified teacher requirements under sectin 9101 f the Elementary and Secndary Educatin Act f The teacher must als achieve a scre n each test that equals r eceeds the average passing scre fr thse states. SECTION 10: TERMS AND CONDITIONS T qualify fr lan frgiveness, yu must nt have had an utstanding balance n a Direct Lan r FFEL prgram lan n Octber 1, 1998, r n the date that yu btained a Direct Lan r FFEL prgram lan after Octber 1, This means that if yu had an utstanding balance n ne r mre Direct Lan r FFEL prgram lans n Octber 1, 1998, r n any Direct Lan r FFEL prgram lans that yu btained while yu had an utstanding balance n a Direct Lan r FFEL prgram lan made n r befre Octber 1, 1998, yu may qualify fr lan frgiveness if yu later paid all f thse lans in full s that yu had n utstanding balance n any Direct Lan r FFEL prgram lan at the time yu btained a new Direct Lan r FFEL prgram lan after Octber 1, Yu are nt eligible t receive frgiveness n a defaulted lan unless yu have first made satisfactry repayment arrangements with the hlder f the defaulted lan. Any lan fr which yu are seeking frgiveness must have been made befre the end f yur five cnsecutive, cmplete academic years f qualifying teaching service. Yu must nt have received benefits thrugh the AmeriCrps Prgram under Subtitle D f Title I f the Natinal and Cmmunity Service Act f 1990 r lan frgiveness under the Direct Lan Public Service Lan Frgiveness Prgram fr the same teaching service fr which yu are seeking frgiveness n yur Direct Lan and/r FFEL prgram lans. Yu must have been emplyed as a full-time teacher fr five cnsecutive, cmplete academic years at an elementary r secndary schl r fr an educatinal service agency that: Is in a schl district that qualifies fr funds under Title I f the Elementary and Secndary Educatin Act f 1965, as amended; Has been selected by the Department based n a determinatin that mre than 30% f the schl's r educatinal service agency's ttal enrllment is made up f children wh qualify fr services prvided under Title I; and Is listed in the Annual Directry f Designated Lw-Incme Schls fr Teacher Cancellatin Benefits (available nline at If this directry is nt available befre May 1 f any year, the previus year's directry may be used. If yur schl r educatinal service agency meets the abve requirements fr at least ne year f yur teaching service, but des nt meet these requirements during subsequent years, yur subsequent years f teaching at the schl r educatinal service agency may be cunted tward the required five years fteachmg. NOTE: All elementary and secndary schls perated by the Bureau f Indian Educatin (BIE) r perated n Indian reservatins by Indian tribal grups under cntract with the BIE qualify as schls serving lw-incme students. If yu were unable t cmplete an academic year f teaching, that year may still be cunted tward the required five cnsecutive, cmplete academic years if: Yu cmpleted at least ne-half f the academic year; and Yur emplyer cnsiders yu t have fulfilled yur cntract requirements fr the academic year fr the purpses f salary increases, tenure, and retirement; and Yu were unable t cmplete the academic year because: Yu returned t pstsecndary educatin, n at least a half-time basis, in an area f study directly related t the perfrmance f the teaching service described abve; r Yu had a cnditin cvered under the Family and Medical Leave Act f 1993 {FMLA); r Page 6 f 8

13 SECTION 10: TERMS AND CONDITIONS (CONTINUED) Yu were called r rdered t active duty status fr mre than 30 days as a member f a reserve cmpnent f the Armed Frces. NOTE: Absence due t a perid f pstsecndary educatin, a cnditin cvered under the FMLA, r active duty service, including the time needed fr yu t resume teaching n later than the beginning f the net regularly scheduled academic year, is nt cnsidered a break in the required five cnsecutive, cmplete academic years. Yu may qualify fr frgiveness based n qualifying teaching service at any cmbinatin f eligible elementary schls, secndary schls, r educatinal service agencies. Hwever: Teaching at ari eligible elerr1entary r secndaiy schl may be cunted nf')>'-if at ieast r1-e.f th~ flvs--~yearsvf' --~teaching was after the academic year. Teaching fr an eligible educatinal service agency may be cunted nly if the cnsecutive five-year perid includes qualifying service fr an eligible educatinal service agency perfrmed after the academic year. If yur five cnsecutive, cmplete years f qualifying teaching service began befre Octber 30, 2004: Yu may receive up t $5,000 in lan frgiveness if yu were: A full-time teacher fr elementary schl students and yu demnstrated knwledge and teaching skills in reading, writing, mathematics, and ther areas f the elementary schl curriculum; r A full-time teacher fr secndary schl students and yu taught in a subject area that was relevant t yur academic majr. Yu may receive up t $17,500 in lan frgiveness if yu were: A highly qualified full-time teacher f mathematics r science t secndary schl students; r A highly qualified full-time special educatin teacher whse primary respnsibility was t prvide special educatin t children with disabilities, and yu taught children with disabilities that crrespnded t yur area f special educatin training and have demnstrated knwledge and teaching skills in the cntent areas f the curriculum that yu taught. If yur five cnsecutive, cmplete years f qualifying teaching service began n r after Octber 30, 2004: Yu may receive up t $5,000 in lan frgiveness if yu were a highly qualified full-time teacher fr elementary r secndary schl students. Yu may receive up t $17,500 in lan frgiveness if yu were: A highly qualified full-time teacher f mathematics r science t secndary schl students; r A highly qualified full-time special educatin teacher whse primary respnsibility was t prvide special educatin t children with disabilities, and yu taught children with disabilities that crrespnded t yur area gf s~egial edygatign training and have demcrnstrnted knwledge and teaching skills in the cntent areas f the curriculum that yu taught. Yu are nt eligible fr frgiveness f mre than a cmbined ttal f $17,500 f principal and interest f yur Direct Lan and/r FFEL prgram lans. Yu must repay any lan balance that remains after frgiveness has been granted. Unless yu instruct yur lan hlder therwise, the frgiveness amunt will be applied t yur lans in the fllwing rder: (1) Direct Unsubsidized Lans r unsubsidized Federal Staffrd Lans, (2) Direct Subsidized Lans r subsidized Federal Staffrd Lans, and {3) Direct Unsubsidized Cnslidatin Lans, Direct Subsidized Cnslidatin Lans, r Federal Cnslidatin Lans. If yu are determined t be eligible fr lan frgiveness under this prgram, yur lan hlder will nt refund any payments that yu made r that were made n yur behalf befre the determinatin f eligibility. If yu receive lan frgiveness based n any false, fictitius, r fraudulent statements that yu make n this frm r n any accmpanying dcuments, yu may be required t repay the amunt frgiven and yu may be subject t civil and criminal penalties under applicable federal law. Page 7 f8

14 SECTION 11: IMPORTANT NOTICES PRIVACY ACT DISCLOSURE NOTICE The Privacy Act f 1974 (5 U.S.C. 552a) requires that the fllwing ntice be prvided t yu: The authrities fr cllecting the requested infrmatin frm and abut yu are 428(b)(2)(A) et seq. and 451 et seq. f the Higher Educatin Act f 1965, as amended (20 U.S.C. 1078(b)(2)(A) et seq. and 20 U.S.C. 1087a et seq.) and the authrity fr cllecting and using yur Scial Security Number (SSN) is 484(a)(4) f the HEA (20 U.S.C. 1091(a)(4)). Participating in the Federal Family Educatin Lan (FFEL) Prgram r the William D. Frd Federal Direct Lan (Direct Lan) Prgram and grving us yur SSN are vluntary, but yu must prvide the requested infrmatin, including yur c.. -':-:...;:-_.;:_.;;:L:~:::--ssl\f; t0"""i3&ttkip-ai'.e-.-...,, ----~ --<-~-"'-~----"- "--=-- -. ;::;_ : -_,..::c--.2_-.; ='--"=:-'""~-,--: ~---~ -~---"---:-'.'-----~-""'~'"- - The principal purpses fr cllecting the infrmatin n this frm, including yur SSN, are t verify yur identity, t determine yur eligibility t receive a lan r a benefit n a lan (such as a deferment, frbearance, discharge, r frgiveness) under the FFEL Prgram and/r Direct Lan Prgram, t permit the servicing f yur lan(s), and, if it becmes necessary, t lcate yu and t cllect n yur lan(s) if yur lan(s) becmes delinquent r in default. We als use yur SSN as an accunt identifier and t permit yu t access yur accunt infrmatin electrnically. The infrmatin in yur file may be disclsed t third parties as authrized under rutine uses in the apprpriate systems f recrds. The rutine uses f this infrmatin include its disclsure t federal, state, r lcal agencies, t ther federal agencies under cmputer matching prgrams, t agencies that we authrize t assist us in administering ur lan prgrams, t private parties such as relatives, present and frmer emplyers, business and persnal assciates, t credit bureau rganizatins, t financial and educatinal institutins, t guaranty agencies, and t cntractrs in rder t verify yur identity, t determine yur eligibility t receive a lan r a benefit n a lan, t permit the servicing r cllectin f yur lan(s), t cunsel yu in repayment effrts, t enfrce the terms f the lan(s), t investigate pssible fraud and t verify cmpliance with federal student financial aid prgram regulatins, t lcate yu if yu becme delinquent in yur lan payments r if yu default, t prvide default rate calculatins, t prvide financial aid histry infrmatin, t assist prgram administratrs with tracking refunds and cancellatins, r t prvide a standardized methd fr educatinal institutins efficiently t submit student enrllment status. In the event f litigatin, we may send recrds t the Department f Justice, a curt, adjudicative bdy, cunsel, party, r witness if the disclsure is relevant and necessary t the litigatin. If this infrmatin, either alne r with ther infrmatin, indicates a ptential vilatin f law, we may send it t the apprpriate authrity fr actin. We may send infrmatin t members f Cngress if yu ask them t help yu with federal student aid questins. In circumstances invlving emplyment cmplaints, grievances, r disciplinary actins, we may disclse relevant recrds t adjudicate r investigate the issues. If prvided fr by a cllective bargaining agreement, we may disclse recrds t a labr rganizatin recgnized under 5 U.S.C. Chapter 71. Disclsures may als be made t qualified researchers under Privacy PAPERWORK REDUCTION NOTICE Accrding t the Paperwrk Reductin Act f 1995, n persns are required t respnd t a cllectin f infrmatin unless such cllectin displays a valid OMB cntrl number. The valid OMB cntrl number fr this infrmatin cllectin is Public reprting burden fr this cllectin f infrmatin is estimated t average 20 minutes (0.33 hurs) per respnse, including time fr reviewing instructins, searching eisting data surces, gathering and maintaining the data needed, and cmpleting and reviewing the cllectin f infrmatin. The bligatin t respnd t this cllectin is required t btain a benefit in accrdance with 34 CFR (f)(l) and 34 CFR (e)(l). If yu have cmments r cncerns regarding the status f yur individual submissin f this frm, cntact yur lan hlder at the address shwn in Sectin 6. Page8f8

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