Income-Based Repayment Plan Request Form Instructions

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1 Incme-Based Repayment Plan Request Frm Instructins Instructins T apply fr the Incme-Based Repayment plan, cmplete the apprpriate sectins f the fllwing applicatin frm and include all required dcumentatin. Nte: FFEL lans are nt eligible fr the Pay As Yu Earn r Incme-Cntingent Repayment plans. Married Brrwers Wh File Taxes Jintly If yu file jintly and yur spuse has eligible lan(s) in repayment that yu wuld like t take int cnsideratin t determine yur mnthly payment, please have yur spuse cmplete the fllwing steps: 1. G t 2. Select Financial Aid Review. 3. Fllw the steps prvided t access the lan infrmatin n NSLDS. 4. After accessing the lan infrmatin, click the Authrizatin buttn at the tp f the page and enter the Aspire Servicing Center SM rganizatin cde: Page 1 f 1 Revised December 2014

2 IDR INCOME-DRIVEN REPAYMENT PLAN REQUEST: Incme-Based Repayment (IBR), Pay As Yu Earn, and Incme-Cntingent Repayment (ICR) plans fr the William D. Frd Federal Direct Lan (Direct Lan) Page 1 f 10 OMB N Frm Apprved Exp. Date 11/30/2015 Prgram and Federal Family Educatin Lan (FFEL) Prgram 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. Check this bx if any f yur infrmatin has changed. SSN Name Address City, State, Zip Telephne Primary Telephne Alternate (ptinal) SECTION 2: REPAYMENT PLAN OR RECERTIFICATION REQUEST - - ( ) - ( ) - Befre cmpleting this frm, carefully read the entire frm. Return the cmpleted frm and any required dcumentatin t the address shwn in Sectin 7. Yu may be able t cmplete yur request nline by visiting StudentLans.gv. Other repayment plans may be available and may ffer a lwer mnthly payment amunt. Yu may pay mre interest ver time under an incme-driven plan and may have t pay federal incme tax n any lan amunt frgiven under an incme-driven plan. A calculatr is available at StudentAid.gv/repayment-estimatr t estimate yur payment amunts under all available repayment plans. 1. Please select the reasn that yu are cmpleting this request by checking bx a, b, r c, belw. a. I am requesting a repayment plan based n my incme Check the plan(s) yu are requesting belw and then cntinue t item 2. Incme-Driven Repayment Plan IBR Pay As Yu Earn ICR I request that my lan hlder determine which f the abve plans I am eligible fr, and place me n the plan with the lwest mnthly payment amunt. Direct Lan Prgram Lans FFEL Prgram Lans Nt Available Nt Available Only IBR is available fr FFEL Prgram lans Yur request will apply t all f yur lans that are eligible fr the plan yu chse. Yu will need t chse a different repayment plan fr lans that are nt eligible fr an incme-driven repayment plan (see sectin 9) r thse lans will be placed n the standard repayment plan. b. I am submitting annual dcumentatin fr the recalculatin f my mnthly payment amunt under my current repayment plan Cntinue t item 2. c. I am requesting that my lan hlder recalculate my current mnthly payment amunt because my circumstances have changed Cntinue t item Check this bx if yu we eligible lans t mre than ne lan hlder. Yu must submit a separate request t each hlder f the lans yu want t repay under the IBR, Pay As Yu Earn, r ICR plan. Yu must prmptly submit t yur lan hlder this cmpleted frm and a cpy f yur mst recent federal incme tax return r federal incme tax return transcript (see Sectin 4), r, if applicable, alternative dcumentatin f yur current incme (see Sectin 5).

3 SECTION 3: SPOUSAL INFORMATION Cmplete this sectin if any f the fllwing apply t yu: Yu file a jint federal incme tax return with yur spuse and yur spuse has eligible lans. Yu have a jint Direct r FFEL Cnslidatin Lan that yu btained with yur spuse as a c-brrwer. Yu and yur spuse have Direct Lans and bth f yu want t repay thse lans under the ICR Plan. 3. Spuse s SSN Spuse s Name 5. Spuse s Date f Birth My spuse and I want t repay ur Direct Lans jintly under the ICR Plan. If yu cmplete this sectin, yur spuse must als sign this frm. By signing, yur spuse is authrizing yur lan hlder t access infrmatin abut his r her federal student lans in the Natinal Student Lan Data System (NSLDS). If yur spuse has FFEL Prgram lans that are nt held by yur lan hlder, yur spuse may need t give yur lan hlder access t his r her lan infrmatin in NSLDS (nslds.ed.gv). Fr mre infrmatin, cntact yur lan hlder. SECTION 4: FAMILY SIZE AND FEDERAL TAX INFORMATION 7. Enter yur family size (see Sectin 9; if yu leave this blank, yur lan hlder will use a family size f ne). 8. Did yu file a federal incme tax return in either f the tw mst recently cmpleted tax years? Yes Cntinue t Item 9. N Skip t Sectin Is yur current incme r yur spuse s current incme (if yu cmpleted Sectin 3 r if yu file a jint federal incme tax return) significantly different than the incme reprted n yur mst recent federal incme tax return? Yes Cntinue t Sectin 5. N Prvide yur mst recent federal incme tax return r transcript. Skip t Sectin 6. SECTION 5: ALTERNATIVE DOCUMENTATION OF INCOME Cmplete this sectin if yu (1) answered N t Questin 8, (2) answered Yes t Questin 9, r (3) if yur lan hlder requires yu t prvide alternative dcumentatin f incme. 10. D yu currently have taxable incme? Check N if yu d nt have any incme r receive nly untaxed incme. Yes Prvide dcumentatin f this incme, as described belw. N By signing this frm, yu are certifying that yu d nt have any taxable incme. 11. If yu cmpleted Sectin 3 r file a jint federal incme tax return with yur spuse, des yur spuse currently have taxable incme? Check N if yur spuse des nt have any incme r receives nly untaxed incme. Yes Prvide dcumentatin f yur spuse s incme, as described belw. N By signing this frm, yur spuse is certifying that he r she des nt have any taxable incme. If yu answered Yes t Items 10 r 11, belw are instructins n hw t dcument yur incme: Yu must prvide dcumentatin f all taxable incme that yu and yur spuse (if applicable) currently receive (fr example, incme frm emplyment, unemplyment incme, dividend incme, interest incme, tips, alimny). D nt reprt untaxed incme such as Supplemental Security Incme, child supprt, r federal r state public assistance. Yu must prvide ne piece f dcumentatin fr each surce f taxable incme. Dcumentatin may include a pay stub, a letter frm yur emplyer listing pay, bank statements, r dividend statements. If dcumentatin is unavailable, attach a signed statement explaining the incme surce(s) and giving the name and the address f the incme surce(s). Unless the frequency is clearly indicated n the dcumentatin that yu prvide, write n yur dcumentatin hw ften yu receive the incme, fr example, twice per mnth r every ther week. The date n any supprting dcumentatin yu prvide must be n lder than 90 days frm the date yu sign this frm. Cpies f riginal dcumentatin are acceptable. Page 2 f 10

4 SECTION 6: BORROWER REQUEST UNDERSTANDINGS, AUTHORIZATION, AND CERTIFICATION I request t use the plan I selected in Sectin 2 t repay my eligible Direct Lan r FFEL Prgram lans held by the hlder t which I submit this frm. If I selected the ptin t allw my lan hlder t chse my plan r I d nt qualify fr the plan(s) I requested, I request my lan hlder place me in the plan with the lwest mnthly payment amunt. If I selected mre than ne plan, I request my lan hlder place me in the plans with the lwest mnthly payment amunt frm the plans that I requested. If mre than ne plan prvides the same initial payment amunt, I understand that my lan hlder will chse the plan that is likely t keep my mnthly payment amunt lwer in subsequent years r prvides terms and cnditins that better limit the ttal cst f my lans. I understand that: (1) If I am entering repayment n my lan fr the first time and d nt prvide my lan hlder with this cmpleted frm and any ther dcumentatin required by my lan hlder, r if I d nt qualify fr the repayment plan that I requested, I will be placed n the standard repayment plan (see Sectin 9). (2) If I am currently repaying my lan under a different repayment plan and want t change t the repayment plan I selected in Sectin 2, my lan hlder may grant me a frbearance fr up t 60 days t cllect and prcess dcumentatin supprting my request fr the selected plan. I am nt required t make lan payments during this perid f frbearance, but interest will cntinue t accrue. Unpaid interest that accrues during this frbearance perid will nt be capitalized (see Sectin 9). (3) If I am in a deferment r frbearance at the time I request ne f the repayment plans listed in Sectin 2, my lan hlder may end the deferment r frbearance early t prcess my new repayment plan request. (4) If I am delinquent in making payments under my current repayment plan at the time I request ne f the repayment plans listed in Sectin 2, my lan hlder may grant me a frbearance t cver any payments that are verdue, r that wuld be due, at the time my request is prcessed. Unpaid interest that accrues during this frbearance perid may be capitalized. (5) If I am requesting the ICR plan, my initial payment amunt will be the amunt f interest that accrues each mnth n my lan until my lan hlder receives the incme dcumentatin needed t calculate my ICR payment amunt. If I cannt affrd the initial interest payments, I may request frbearance by cntacting my lan hlder. 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 text messages. I certify that all f the infrmatin I have prvided n this frm and in any accmpanying dcumentatin is true, cmplete, and crrect t the best f my knwledge and belief. Brrwer Signature Date - - Spuse s Signature (if required) Date - - Nte: Yur spuse s signature is required if yu cmpleted Sectin 3 and/r cmpleted Item 11. SECTION 7: WHERE TO SEND THE COMPLETED REQUEST Return the cmpleted frm and any required dcumentatin t: (If n address is shwn, return t yur lan servicer.) Aspire Servicing Center P.O. Bx West Des Mines, IA Fax: (515) If yu need help cmpleting this frm, call: (If n telephne number is shwn, call yur lan servicer.) (800) Page 3 f 10

5 SECTION 8: INSTRUCTIONS FOR COMPLETING THE FORM Type r print using dark ink. Enter dates as mnth-day-year (mm-dd-yyyy). Use nly numbers. Example: January 31, 2014 = Include yur name and accunt number n any dcumentatin that yu are required t submit with this frm. If yu need help cmpleting this frm, cntact yur lan hlder. If yu want t apply fr a repayment plan n lans that are held by different lan hlders, yu must submit a separate request t each lan hlder. Return the cmpleted frm and any required dcumentatin t the address shwn in Sectin 7. SECTION 9: DEFINITIONS The William D. Frd Federal Direct Lan (Direct Lan) Prgram includes Direct Subsidized Lans, Direct Unsubsidized Lans, Direct PLUS Lans, and Direct Cnslidatin Lans. The Federal Family Educatin Lan (FFEL) Prgram includes Federal Staffrd Lans (bth subsidized and unsubsidized), Federal PLUS Lans, Federal Cnslidatin Lans, and Federal Supplemental Lans fr Students (SLS). The Incme-Based Repayment (IBR) plan is a repayment plan with mnthly payments that are limited t 15% (10% if yu are a new brrwer) f yur discretinary incme, divided by 12. Discretinary incme fr this plan is the amunt by which yur adjusted grss incme exceeds 150% f the pverty guideline amunt fr yur state f residence and family size. T initially qualify fr IBR and t cntinue making incme-based payments under this plan, yu must have a partial financial hardship (see definitin). Eligible lans fr the IBR plan are Direct Lan and FFEL Prgram lans ther than: (1) a lan that is in default, (2) a Direct r Federal PLUS Lan made t a parent brrwer, r (3) a Direct r Federal Cnslidatin Lan that repaid a Direct r Federal PLUS Lan made t a parent brrwer. Federal Perkins Lans, HEAL lans r ther health educatin lans, and private educatin lans are nt eligible t be repaid under the IBR plan. Yu are a new brrwer fr the IBR plan if (1) yu have n utstanding balance n a Direct Lan r FFEL Prgram lan as f July 1, 2014 r have n utstanding balance n a Direct Lan r FFEL Prgram lan when yu btain a new lan n r after July 1, The Pay As Yu Earn plan is a repayment plan with mnthly payments that are limited t 10% f yur discretinary incme, divided by 12. Discretinary incme fr this plan is the amunt by which yur adjusted grss incme exceeds 150% f the pverty guideline amunt fr yur state f residence and family size. T initially qualify fr the Pay As Yu Earn plan and t cntinue t make incme-based payments under this plan, yu must have a partial financial hardship (see definitin) and be a new brrwer (see definitin). Eligible lans fr the Pay As Yu Earn plan are Direct Lan Prgram lans received by a new brrwer ther than: (1) a lan that is in default, (2) a Direct PLUS Lan made t a parent brrwer, r (3) a Direct Cnslidatin Lan that repaid a Direct r Federal PLUS Lan made t a parent brrwer. FFEL Prgram Lans, Federal Perkins Lans, HEAL lans r ther health educatin lans, and private educatin lans are nt eligible t be repaid under the Pay As Yu Earn plan. Yu are a new brrwer fr the Pay As Yu Earn plan if: (1) yu have n utstanding balance n a Direct Lan r FFEL Prgram lan as f Octber 1, 2007 r have n utstanding balance n a Direct Lan r FFEL Prgram lan when yu btain a new lan n r after Octber 1, 2007, and (2) yu receive a disbursement f a Direct Subsidized Lan, Direct Unsubsidized Lan, r a Direct PLUS Lan made t a student brrwer n r after Octber 1, 2011, r yu receive a Direct Cnslidatin Lan based n an applicatin received n r after Octber 1, Hwever, yu are nt cnsidered a new brrwer if the Direct Cnslidatin Lan yu receive repays lans that wuld make yu ineligible under part (1) f this definitin. The Incme-Cntingent Repayment (ICR) plan is a repayment plan with mnthly payments that are the lesser f (1) what yu wuld pay n a 12-year standard repayment plan multiplied by an incme percentage factr r (2) 20% f yur discretinary incme divided by 12. Page 4 f 10

6 Discretinary incme fr this plan is the amunt by which yur adjusted grss incme exceeds the pverty guideline amunt fr yur state f residence and family size. Eligible lans fr the ICR plan are Direct Lan Prgram lans ther than: (1) a lan that is in default, (2) a Direct PLUS Lan made t a parent brrwer, r (3) a Direct PLUS Cnslidatin Lan (these are Direct Cnslidatin Lans made based n an applicatin received prir t July 1, 2006 that repaid Direct r Federal PLUS Lans made t a parent brrwer). FFEL Prgram Lans, Federal Perkins Lans, HEAL lans r ther health educatin lans, and private educatin lans are nt eligible t be repaid under the ICR plan. A Direct Cnslidatin Lan made based n an applicatin received n r after July 1, 2006 that repaid a Direct r Federal PLUS Lan made t a parent brrwer, is eligible fr the ICR plan. A partial financial hardship is an eligibility requirement fr the IBR and Pay As Yu Earn plans. Yu have a partial financial hardship when the annual amunt due n all f yur eligible lans r, if yu are married and file a jint federal incme tax return, the annual amunt due n all f yur eligible lans and yur spuse s eligible lans, exceeds 10% (fr the Pay As Yu Earn plan and fr new brrwers under the IBR plan) r 15% f the amunt by which yur adjusted grss incme (AGI) exceeds 150% f the annual pverty guideline amunt fr yur family size and state f residence. Fr bth the IBR and Pay As Yu Earn plans, the annual amunt f payments due is calculated based n the greater f (1) the ttal amunt wed n eligible lans at the time thse lans initially entered repayment, r (2) the ttal amunt wed n eligible lans at the time yu initially request the IBR r Pay As Yu Earn plan. The annual amunt f payments due is calculated using a standard repayment plan with a 10-year repayment perid, regardless f lan type. If yu are married and file a jint federal incme tax return, yur AGI includes yur spuse s incme.the pverty guideline amunt is the figure fr yur state and family size frm the pverty guidelines published annually by the U.S. Department f Health and Human Services (HHS). The HHS pverty guidelines are used fr purpses such as determining eligibility fr certain federal benefit prgrams. If yu are nt a resident f a state identified in the pverty guidelines, yur pverty guideline amunt is the amunt used fr the 48 cntiguus states. Family size includes yu, yur spuse, and yur children (including unbrn children wh will be brn during the year fr which yu certify yur family size), if the children will receive mre than half their supprt frm yu. It includes ther peple nly if they live with yu nw, they receive mre than half their supprt frm yu nw, and they will cntinue t receive this supprt frm yu fr the year that yu certify yur family size. Supprt includes mney, gifts, lans, husing, fd, clthes, car, medical and dental care, and payment f cllege csts. Fr the purpses f these repayment plans, yur family size may be different frm the number f exemptins yu claim n yur federal incme tax return. Capitalizatin is the additin f unpaid interest t the principal balance f yur lan. This will increase the principal balance and the ttal cst f yur lan. The hlder f yur Direct Lans is the U.S. Department f Educatin (the Department). The hlder(s) f yur FFEL Prgram lan(s) may be a lender, secndary market, guaranty agency, r the Department. Yur lan hlder(s) may use a servicer t handle billing, payment, repayment ptins, and ther cmmunicatins n yur lans. References t yur lan hlder n this frm mean either yur lan hlder(s) r yur servicer. The standard repayment plan has a fixed mnthly payment amunt ver a repayment perid f up t 10 years fr lans ther than Direct r Federal Cnslidatin Lans, r up t 30 years fr Direct and Federal Cnslidatin Lans. Page 5 f 10

7 SECTION 10: ELIGIBILITY REQUIREMENTS INFORMATION ABOUT THE IBR AND PAY AS YOU EARN PLANS: T initially qualify t repay yur lan under the IBR r Pay As Yu Earn plan and t cntinue t qualify t make payments based n yur incme, yu must have a partial financial hardship (as defined in Sectin 9). If yu are married and file a jint federal incme tax return, yur lan hlder will als take yur spuse s incme and eligible lans int accunt when determining whether yu have a partial financial hardship. Fr the Pay As Yu Earn plan, yu must be a new brrwer as defined in Sectin 9. Althugh the Pay As Yu Earn plan is available nly fr Direct Lan Prgram lans, the Department will take any FFEL Prgram lans that yu have int accunt when determining whether yu have a partial financial hardship except fr: (1) a FFEL Prgram lan that is in default, (2) a Federal PLUS Lan made t a parent brrwer, r (3) a Federal Cnslidatin Lan that repaid a Federal r Direct PLUS Lan made t a parent brrwer. After entry int the IBR r Pay As Yu Earn plan, yu must annually certify yur family size and prvide incme dcumentatin fr determinatin f whether yu cntinue t have a partial financial hardship. Yur lan hlder will ntify yu f the deadline by which yu must prvide this dcumentatin. Yur mnthly payment amunt may be adjusted annually. The new payment amunt may be higher r lwer, depending n the incme dcumentatin and family size infrmatin yu prvide each year. If yu d nt prvide updated incme dcumentatin annually, within 10 days f the deadline prvided by yur lan hlder, after requested t d s by yur lan hlder, yur payment amunt will be the 10-year standard payment amunt calculated at the time that yu initially entered the IBR r Pay As Yu Earn plan and any utstanding interest will be capitalized (added t yur principal balance). Yu will never pay mre per mnth under the IBR r Pay As Yu Earn plan than yu wuld n the 10-year standard repayment plan, based upn the amunt wed n yur eligible lans at the time yu initially entered the IBR r Pay As Yu Earn plan. Under the IBR r Pay As Yu Earn plan, yur mnthly payment may be less than the mnthly accruing interest. On subsidized lans, yu are nt required t pay any mnthly accrued interest that exceeds yur mnthly payment amunt fr a maximum f three cnsecutive years frm the date that yu start repaying yur lans under the IBR r Pay As Yu Earn plan. The three-year cnsecutive perid limit des nt include any perid during which yu receive an ecnmic hardship deferment. On unsubsidized lans, all accruing interest is yur respnsibility. If yu are determined t n lnger have a partial financial hardship r yu leave the IBR r Pay As Yu Earn plan, any unpaid interest will be capitalized (added t yur principal balance). Hwever, if yu are in the Pay As Yu Earn plan and are determined t n lnger have a partial financial hardship, the amunt that is capitalized is limited t 10% f the utstanding principal balance n yur lans at the time that yu entered the Pay As Yu Earn plan. If yu leave the IBR plan, yu will be placed n the standard repayment plan and yur mnthly payment amunt will be calculated based n the utstanding balance f yur eligible lans at the time yu leave the IBR plan and the repayment perid remaining fr yur lans. If yu wish t repay yur lans under a different repayment plan, yu must first make ne payment under the standard repayment plan r make a reduced payment under a frbearance agreement with yur lan hlder while yu are n the standard repayment plan. If yu leave the Pay As Yu Earn Plan, yu may change t any ther repayment plan fr which yu qualify. Under the IBR and Pay As Yu Earn plans, if yur lan is nt repaid in full after yu have made the equivalent f 20 years (fr the Pay As Yu Earn plan and fr new brrwers under the IBR plan) r 25 years (fr all ther brrwers under the IBR plan) f qualifying mnthly payments and that many years have elapsed, any remaining debt will be frgiven. If yu receive an ecnmic hardship deferment, any mnths f ecnmic hardship deferment are cnsidered the equivalent f qualifying payments. Mnths fr which yu receive any ther type f deferment r mnths f frbearance are nt cunted as qualifying payments, and d nt cunt tward the 20- r 25-year frgiveness perid. Any amunt frgiven under the IBR plan r Pay As Yu Earn plan may be cnsidered incme by the Internal Revenue Service and subject t federal incme tax. Page 6 f 10

8 SECTION 10: ELIGIBILITY REQUIREMENTS (CONTINUED) INFORMATION ABOUT THE ICR PLAN: All Direct Lan brrwers are eligible t repay their eligible lans n the ICR plan. Yu are nt required t have a partial financial hardship t use the ICR plan. T repay eligible lans under the ICR plan, yu must submit dcumentatin f yur incme. If yu are married and file a jint federal tax return, the Department will als take yur spuse s incme int accunt when calculating yur mnthly payment amunt. If yu are married, yu and yur spuse may chse t repay yur lans jintly under the ICR plan. If yu chse t repay jintly, the Department will use yur cmbined incme and Direct Lan debt t calculate a jint ICR payment amunt, and will then prrate the jint payment amunt t determine separate ICR mnthly payment amunts fr yu and yur spuse that are prprtinate t each individual s share f the cmbined Direct Lan debt. Yu and yur spuse may select this ptin under the ICR plan regardless f yur federal tax return filing status. After entry int the ICR plan, yu must annually certify yur family size and prvide incme dcumentatin s that the Department can adjust yur payment amunt t reflect mre recent incme infrmatin. Yur new payment amunt may be higher r lwer, depending n the incme dcumentatin and family size infrmatin yu prvide each year. The Department will ntify yu when yu must prvide this dcumentatin. If yu d nt prvide updated incme dcumentatin annually by the deadline prvided by the Department, yur payment amunt will be calculated based n a 10-year standard repayment plan using the lan balance at the time yu entered repayment under the ICR repayment plan. Under the ICR plan, yur mnthly payment may be less than the mnthly accruing interest. The accruing interest that is nt satisfied by yur mnthly payment will be capitalized annually. Yu will receive a ntice telling yu when the interest will be capitalized, and yu will have the pprtunity t pay that interest befre it is capitalized. While yu remain in ICR, the amunt f interest that is capitalized will be limited t 10% f the utstanding principal balance n yur lans at the time that yu entered repayment. Under the ICR plan, if yur lan is nt repaid in full after yu have made the equivalent f 25 years f qualifying mnthly payments and at least 25 years have elapsed, any remaining debt will be frgiven. If yu receive an ecnmic hardship deferment, any mnths f ecnmic hardship deferment are cnsidered the equivalent f qualifying payments. Mnths fr which yu receive any ther type f deferment r mnths f frbearance are nt cunted as qualifying payments, and d nt cunt tward the 25-year frgiveness perid. Any amunt frgiven under the ICR plan may be cnsidered incme by the Internal Revenue Service and subject t federal incme tax. IMPORTANT INFORMATION ABOUT ALTERNATIVE DOCUMENTATION OF INCOME: YOU ARE REQUIRED t prvide alternative dcumentatin f yur incme if: Yu did nt file a federal tax return fr either f the tw mst recently cmpleted tax years; r Yu have been ntified by yur lan hlder(s) that alternative dcumentatin f yur incme is required. YOU MAY prvide alternative dcumentatin f yur incme if yur Adjusted Grss Incme (AGI), as reprted n yur mst recently filed federal tax return, des nt reasnably reflect yur current incme, fr example, because f a lss f r change in emplyment by yu r yur spuse. YOU ARE NOT REQUIRED t prvide alternative dcumentatin f yur incme if yu can prvide a cpy f yur mst recently filed federal tax return r an IRS tax return transcript frm either f the tw mst recently cmpleted tax years; and that dcumentatin reasnably reflects yur current incme. IMPORTANT INFORMATION ABOUT PUBLIC SERVICE LOAN FORGIVENESS (PSLF): The Public Service Lan Frgiveness Prgram allws eligible brrwers t cancel the remaining balance f their Direct Lans after they have served full time at a qualifying emplyer fr at least 10 years, while making 120 qualifying lan payments, including payments under the IBR, Pay As Yu Earn, and ICR plan. Qualifying emplyers include gvernmental rganizatins and many nt-fr-prfit rganizatins. Fr mre infrmatin abut PSLF, see StudentAid.gv/PublicService. Page 7 f 10

9 SECTION 11: SAMPLE PAYMENT AMOUNTS Belw are tw tables that prvide examples f mnthly and ttal payment amunts under the Standard, Graduated, and Extended repayment plans. These figures are estimates, and use an interest rate f 8.25%. Varius factrs, including yur actual interest rate and the amunt f yur lan debt, may cause yur payment amunt t differ frm the payment amunts shwn in these tables. Yur lan hlder will prvide yu with the actual mnthly payment amunt after yu select a repayment plan. Table 1. Sample Amunts Under the Standard, Graduated, Extended-Fixed, and Extended-Graduated Plans fr Direct and FFEL Subsidized, Unsubsidized, and PLUS Lans Standard (10 years) Graduated (10 years) Extended-Fixed (25 years) Extended-Graduated (25 years) Debt Minimum Minimum $20,000 $245 $29,437 $144 $431 $32,177 Nt Eligible - Nt Eligible - - $30,000 $368 $44,155 $216 $647 $48,265 Nt Eligible - Nt Eligible - - $40,000 $491 $58,873 $287 $862 $64,353 $315 $94,614 $275 $417 $101,515 $50,000 $613 $73,592 $359 $1,078 $80,442 $394 $118,268 $344 $521 $126,899 $60,000 $736 $88,310 $431 $1,294 $96,530 $473 $141,921 $413 $625 $152,280 $70,000 $859 $103,028 $503 $1,509 $112,618 $552 $165,575 $481 $730 $177,664 $80,000 $981 $117,747 $575 $1,725 $128,706 $631 $189,228 $550 $834 $203,046 $90,000 $1,104 $132,465 $647 $1,940 $144,795 $710 $212,882 $619 $938 $228,427 Table 2. Sample Amunts Under the Standard, Graduated, Extended-Fixed, and Extended-Graduated Plans fr Direct and FFEL Cnslidatin Lans Standard (10-30 years) Graduated (10-30 years) Extended-Fixed (25 yrs.) Extended-Graduated (25 years) Debt Repayment Perid Repayment Perid Minimum Minimum $20, years $170 $40, years $138 $241 $44,420 Nt Eligible - Nt Eligible - - $30, years $256 $61, years $206 $362 $66,631 Nt Eligible - Nt Eligible - - $40, years $315 $94, years $275 $417 $101,515 $315 $94,614 $275 $417 $101,515 $50, years $394 $118, years $344 $521 $126,899 $394 $118,268 $344 $521 $126,899 $60, years $451 $162, years $413 $549 $166,145 $473 $141,921 $413 $625 $152,280 $70, years $526 $189, years $481 $640 $193,841 $552 $165,575 $481 $730 $177,664 $80, years $601 $216, years $550 $732 $221,531 $631 $189,228 $550 $834 $203,046 $90, years $676 $243, years $619 $823 $249,228 $710 $212,882 $619 $938 $228,427 Page 8 f 10

10 SECTION 11: SAMPLE PAYMENT AMOUNTS (CONTINUED) Belw are three tables that prvide examples f mnthly and ttal payment amunts under the IBR, Pay As Yu Earn, and ICR Plans. These figures are estimates, and use an interest rate f 8.25%. The figures als assume that yu are single, d nt have anyne else in yur husehld, and that yu live in ne f the 48 cntiguus states. Varius factrs, including yur actual interest rate, the amunt f yur lan debt, yur incme, and whether and hw quickly yur incme rises (these figures assume incme increases 5% per year), may cause yur payment amunt t differ frm the payment amunts shwn in these tables. These figures use the 2013 Pverty Guidelines (published by the U.S. Department f Health and Human Services) and Incme Percentage Factrs. Table 3. Sample Amunts fr the Incme-Based Repayment (IBR) Plan fr Thse Wh Are Nt New Brrwers On/After July 1, 2014 Starting incme f $25,000 Starting incme f $40,000 Starting incme f $60,000 Debt $20,000 $97 $245 $43, Nt Eligible Nt Eligible $40,000 $97 $491 $89, $285 $491 $72, Nt Eligible $60,000 $97 $642 $94, $285 $736 $148, $535 $736 $97, $80,000 $97 $642 $94, $285 $981 $193, $535 $981 $156, $100,000 $97 $642 $94, $285 $1,227 $201, $535 $1,227 $236, Table 4. Sample Amunts fr the Pay As Yu Earn Plan fr Eligible Brrwers & IBR Plan fr Thse Wh Are New Brrwers On/After July 1, 2014 Starting incme f $25,000 Starting incme f $40,000 Starting incme f $60,000 Debt $20,000 $65 $245 $38, $190 $245 $31, Nt Eligible $40,000 $65 $309 $40, $190 $491 $85, $356 $491 $64, $60,000 $65 $309 $40, $190 $625 $89, $356 $736 $129, $80,000 $65 $309 $40, $190 $625 $89, $356 $981 $154, $100,000 $65 $309 $40, $190 $625 $89, $356 $1,046 $155, Table 5. Sample Amunts fr the Incme-Cntingent Repayment (ICR) Plan Starting incme f $25,000 Starting incme f $40,000 Starting incme f $60,000 Debt $20,000 $151 $199 $43, $193 $219 $33, $219 $251 $30, $40,000 $225 $423 $96, $385 $438 $67, $438 $502 $61, $60,000 $225 $694 $146, $475 $658 $106, $658 $754 $92, $80,000 $225 $1,018 $162, $475 $939 $176, $809 $1,015 $124, $100,000 $225 $1,018 $163, $475 $1,360 $281, $809 $1,296 $171, Page 9 f 10

11 SECTION 12: IMPORTANT NOTICES Privacy Act Ntice. 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 421 et seq. and 451 et seq. f the Higher Educatin Act f 1965, as amended (20 U.S.C et seq. and 20 U.S.C. 1087a et seq.) and the authrities fr cllecting and using yur Scial Security Number (SSN) are 428B(f) and 484(a)(4) f the HEA (20 U.S.C (f) and 1091(a)(4)) and 31 U.S.C. 7701(b). Participating in the Federal Family Educatin Lan (FFEL) Prgram r the William D. Frd Federal Direct Lan (Direct Lan) Prgram and giving us yur SSN are vluntary, but yu must prvide the requested infrmatin, including yur SSN, t participate. 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 and/r Direct Lan Prgrams, t permit the servicing f yur lan(s), and, if it becmes necessary, t lcate yu and t cllect and reprt n yur lan(s) if yur lan(s) becmes delinquent r defaults. 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, n a caseby-case basis r under a cmputer matching prgram, t third parties as authrized under rutine uses in the apprpriate systems f recrds ntices. The rutine uses f this infrmatin include, but are nt limited t, its disclsure t federal, state, r lcal agencies, t private parties such as relatives, present and frmer emplyers, business and persnal assciates, t cnsumer reprting agencies, t financial and educatinal institutins, and t guaranty agencies 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 enfrce the terms f the lan(s), t investigate pssible fraud and t verify cmpliance with federal student financial aid prgram regulatins, r t lcate yu if yu becme delinquent in yur lan payments r if yu default. T prvide default rate calculatins, disclsures may be made t guaranty agencies, t financial and educatinal institutins, r t state agencies. T prvide financial aid histry infrmatin, disclsures may be made t educatinal institutins. T assist prgram administratrs with tracking refunds and cancellatins, disclsures may be made t guaranty agencies, t financial and educatinal institutins, r t federal r state agencies. T prvide a standardized methd fr educatinal institutins t efficiently submit student enrllment statuses, disclsures may be made t guaranty Page 10 f 10 agencies r t financial and educatinal institutins. T cunsel yu in repayment effrts, disclsures may be made t guaranty agencies, t financial and educatinal institutins, r t federal, state, r lcal agencies. 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 be made t ur cntractrs fr the purpse f perfrming any prgrammatic functin that requires disclsure f recrds. Befre making any such disclsure, we will require the cntractr t maintain Privacy Act safeguards. Disclsures may als be made t qualified researchers under Privacy Act safeguards. Paperwrk Reductin Ntice. Accrding t the Paperwrk Reductin Act f 1995, n persns are required t respnd t a cllectin f infrmatin unless it displays a currently valid OMB cntrl number. Public reprting burden fr this cllectin f infrmatin is estimated t average 0.5 hurs (30 minutes) per respnse, including the time fr reviewing instructins, searching existing data resurces, gathering and maintaining the data needed, and cmpleting and reviewing the infrmatin cllectin. Individuals are bligated t respnd t this cllectin t btain a benefit in accrdance with 34 CFR , , r Send cmments regarding the burden estimate(s) r any ther aspect f this cllectin f infrmatin, including suggestins fr reducing this burden t the U.S. Department f Educatin, 400 Maryland Avenue, SW, Washingtn, DC r e- mail and reference OMB Cntrl Number Nte: Please d nt return the cmpleted frm t this address. If yu have questins regarding the status f yur individual submissin f this frm, cntact yur lan hlder(s) (see Sectin 7).

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