ECONOMIC HARDSHIP DEFERMENT REQUEST - Uheaa

TILP

ECONOMIC HARDSHIP DEFERMENT REQUEST

Terrel H. Bell Teaching Incentive Loan Program (TILP)

Use this form only for your outstanding Teaching Incentive Loan Program student loan(s)

SECTION 1: BORROWER IDENTIFICATION

SSN: Name: Address: City, State, ZIP:

Telephone ? Home: (

)

Telephone ? Other: (

)

Email Address (Optional):

Before answering any questions, carefully read the entire form

SECTION 2: DEFERMENT REQUEST

"I certify that I am temporarily unable to make payments on my Terrel H. Bell Teaching Incentive Loan Program (TILP) loan due to a temporary financial hardship."

A. Describe the cause of your temporary financial hardship. (This is required. Attach additional pages if necessary.)

B. Describe the steps you are taking to resolve the circumstances described above. (This is required. Attach additional pages if necessary.)

SECTION 3: BORROWER CERTIFICATIONS AND SIGNATURE

I understand that I am not required to make payments during my deferment period and that interest will not be charged on my TILP loans during that period. I also understand that any outstanding interest accrued before the deferment period will be capitalized (added to the principal balance) when the deferment period ends and that I can prevent the capitalization by paying that accrued interest before the deferment period ends.

I certify that the information I provided in Sections 1 and 2 above is true and correct.

I certify that I am willing to repay my educational loan; however, I am temporarily unable to make payments at this time. I agree to the terms of this deferment and agree to repay my loan upon the expiration of this deferment in accordance with the terms of my promissory note

I authorize the entity to which I submit this request (i.e., the school, the lender, the guaranty agency, the U.S. Department of Education, and their respective agents and contractors) to contact me regarding my request or my loan(s), including repayment of my loan(s), at the number that I provide on this form or any future number that I provide for my cellular telephone or other wireless device using automated telephone dialing equipment or artificial or prerecorded voice or text messages.

Borrower's Signature _______________________________________________________________________ Date

SECTION 4: WHERE TO SEND THE COMPLETED DEFERMENT REQUEST

RETURN THE COMPLETED DEFERMENT REQUEST AND ANY REQUIRED DOCUMENTATION TO:

UHEAA Terrel H. Bell Teaching Incentive Loan Program (TILP) PO Box 145110 Salt Lake City, UT 84114-5110

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