Form ED Form 4-619 ED Form 4-619 CLFR remittance form ED 4-619

FFEL CONSOLIDATION LOAN REBATE FEE
REPORT and REMITTANCE FORM
Collection Type – CLRF
1. Lender ID:

8

__ __ __ __ __

2. Servicer ID:

7

__ __ __ __ __ (Optional)

3. Reporting Period: __ __ / __ __ __ __
(MM) (YYYY)

4. Consolidation Loans Subject to the 1.05% fee; applicable rate:
5. Number of Loans:

0 0

0 8

7

5 0

__ __ __ , __ __ __ , __ __ __

6. End-of-Month Principal Balance:

$ __ __ __ , __ __ __ , __ __ __ , __ __ __ . __ __

7. EOM Accrued Unpaid Interest Balance: $ __ __ __ , __ __ __ , __ __ __ , __ __ __ . __ __

8. Consolidation Loans Subject to the 0.62% fee, applicable rate: 0
9. Number of Loans:

0

0 5

1

6

7

__ __ __ , __ __ __ , __ __ __

10. End-of-Month Principal Balance:

$ __ __ __ , __ __ __ , __ __ __ , __ __ __ . __ __

11. EOM Accrued Unpaid Interest Balance: $ __ __ __ , __ __ __ , __ __ __ , __ __ __ . __ __

12. Total Consolidation Loan Rebate Fee: $ __ __ __ , __ __ __ , __ __ __ . __ __
13. Lender’s Check Number: __ __ __ __ __ __ __ __ __ __ __ __

14. Lender Name: _________________________________________________________________
15. Signature: _________________________________

16. Date: ____________________

17. Typed or Printed Name & Title: ___________________________________________________
18. Contact Name & Phone #: ________________________________________________________
ED Form 4-619

OMB No.: 1845-0046
Expiration Date: 05/31/2017

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Consolidation Loan Rebate Fee Report
Instructions
Where to Submit: Mail this completed Consolidation Loan Rebate Fee Report and a check made payable
to the "U.S. Department of Education," with a notation for, and in the amount of, the Fee to:
U.S. Department of Education,
P. O. Box 979066, St. Louis, MO 63197-9000
If you wish to pay the Fee by Automated Clearing House (ACH) instead of by check, call the U. S. Department of Education at (202) 377-3324/3322 for further instructions. The words "your" and "you" in these
instructions refer to the lending institution for which this Consolidation Loan Rebate Fee Report is being
prepared, or the person at the institution preparing the report.
Applicability: This Consolidation Loan Rebate Fee Report is used to report to the U.S. Department of
Education (ED) the Federal Consolidation Loan Interest Payment Rebate Fee authorized by subsection
428C(f) of the Higher Education Act of 1965, as amended. A servicer providing loan services to several different lenders must submit a separate Consolidation Loan Rebate Fee Report for each lender that it services.
Help on completing this Consolidation Loan Rebate Fee Report and on correcting or adjusting prior Reports
can be obtained from ED by calling (202) 377-3324/3322. NOTE: A lender holding one or more Federal
Consolidation Loans at the end of the month must submit a payment for the Consolidation Loan Rebate Fee
within 30 days of the end of the month for which the Fee is calculated.
Form Preparation: Submit the Consolidation Loan Rebate Fee Report using a photocopy of the front
page of this form, or by typing or computer generating a facsimile of the front page of this form. If a facsimile is produced, include the form title, the ED form number, and all material in the boxes on the front page of
this form. The facsimile must be produced on 8½ x 11 inch plain white paper, and all items must be arranged
in the same order as on the form. The dollar symbols ($) must be included, but the lines outlining the boxes
and the underlines for each item may be omitted. The instructions for this form may also be omitted. ED
may reject a facsimile that does not meet these criteria.
Fee Calculation: The Federal Consolidation Loan Interest Payment Rebate Fee is calculated and paid
monthly to ED. It is equal on a monthly basis to 0.0875 percent of the unpaid balance of principal and the
accrued unpaid interest on all Federal Consolidation Loans disbursed after October 1, 1993, and held by the
lender on the last day of the month. (This is equal to an annualized rate of 1.05 percent.) Except for loans
based on applications received during the period from October 1, 1998 through January 31, 1999, inclusive,
for which the rebate is equal on a monthly basis to .05167 percent of the unpaid balance of principal and the
accrued unpaid interest. (This is equal to an annualized rate of 0.62 percent.) Use the item-by-item instructions in the following paragraphs to calculate the Fee and to complete the Consolidation Loan Rebate Fee
Report on the front page of this form.
1. Lender ID: Enter your six-digit lender identification number (LID). The “8” has been pre-filled for
you.
2. Servicer ID: Enter your six-digit servicer identification number, if applicable. The “7” has been prefilled for you.
3. Reporting Period: Enter the date of the last day of the month of the reporting period for which this
Consolidation Loan Rebate Fee Report is being submitted. Enter the date in a "month/year" format. Enter the
month as two digits. Enter the year as four digits. For the purpose of the Consolidation Loan Rebate Fee
Report, a month is always a calendar month, starting on the first of the month and ending on the last day (the
30th or 31st, except for February). A calendar month reporting cycle must be used for the Consolidation
Loan Rebate Fee Report even if you use a different reporting cycle (e.g. from the 26th day of one month to
the 25th day of the following month) for internal or other reporting purposes.
4. Applicable rate for Consolidation Loans Subject to the 1.05% fee: This field has been pre-filled for
you.

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5. Number of Loans: Enter the number of loans subject to the 1.05% fee used to calculate the
Consolidation Loan Rebate Fee. To determine this number, review all Federal Consolidation Loans held by
you at the end of the month and identify the loans that were disbursed on or after October 1, 1993, except for
loans based on applications received during the period from October 1, 1998 through January 31, 1999,
inclusive which are subject to the 0.62% fee. Include a loan even if you were not the originating lender, you
only purchased it at a later date. Include all loans eligible for insurance, even if an insurance claim has been
filed, but not paid, as of close of business on the last day of the month.
6. End-of-Month Principal Balance: Enter the Principal Balance used to determine the Consolidation
Loan Rebate Fee. For all Federal Consolidation Loans meeting the requirements in item 5, Number of Loans,
determine the unpaid principal balance at the end of the day on the last day of the month. Payments received
from borrowers on the last day of the month should be credited prior to determining the unpaid principal
balance. Add the unpaid principal balances for all loans to determine the End-of-Month Principal Balance.
You may round this total to the nearest dollar if desired.
7. End-of-Month Accrued Unpaid Interest Balance: Enter the End-of-Month Accrued Unpaid Interest
Balance used to determine the Consolidation Loan Rebate Fee. For each loan for which an End-of-Month
Principal Balance (see item 6) was determined, determine its accrued unpaid interest balance at the end of the
day on the last day of the month. Payments received from borrowers or ED on the last day of the month
should be credited prior to determining the accrued unpaid interest balance. Add the accrued unpaid interest
balances for all loans to determine the End-of-Month Accrued Unpaid Interest Balance. You may round this
total to the nearest dollar if desired.
(Items 8 through 11 – Repeat the instructions for Items 4 through 7, as they apply to Consolidation loans
based on applications received during the period from October 1, 1998 through January 31,1999, inclusive,
which are subject to the 0.62% fee.)
12. Consolidation Loan Rebate Fee: Enter the amount of the Federal Consolidation Loan Interest
Payment Rebate Fee being paid at the time this report is submitted. To determine the amount of the Fee for
the month, add the End-of-Month Principal Balance (see item 6) to the End-of-Month Accrued Interest
Balance (see item 7). Multiply this sum by 0.0875 percent (that is, .0008750). To this amount, add the Endof-Month Principal Balance (see item 10) to the End-of-Month Accrued Interest Balance (see item 11) and
then multiplied by .05167 percent (that is, .0005167). Round the resulting product to the nearest dollar if
desired. Prepare a check for this amount made out to the "U.S. Department of Education," and with the
notation "Consolidation Loan Rebate Fee." (Refer to the "Where to Submit" paragraph at the beginning of the
second page of this form for mailing instructions.) Please make sure that the amount reported in this item is
the same as the amount of the check being submitted.
13. Lender’s Check Number: Enter the number of your check.
14. Lender Name: Enter the name of the lender that holds the Federal Consolidation Loans reported in
the Consolidation Loan Rebate Fee Report.
15. Signature: Read the certification statement and sign the form in ink. Forms signed with signature
stamps and unsigned forms will be returned for a valid signature.
16. Date: Enter the date the form is signed.
17. Typed Name & Title: Type or print (do not write) the name and title of the official signing the form.
18. Contact Name & Phone #: Print the name and the telephone number (including area code) of the
person who can answer questions from ED about the holder's Federal Consolidation Loan portfolio and about
this Consolidation Loan Rebate Fee Report. This person may be a representative of the servicer, or
representative of the lending institution holding the loans.
Reporting Burden: According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless such collection displays a valid OMB control number. The valid OMB control number for this information collection is 1845-xxxx.
The time required to complete this information collection is estimated to average 1 hour per response, including the time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any
comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department
of Education, Washington, D.C. 20202-4651. If you have comments or concerns regarding the status of your individual submission of
this form, write directly to U.S. Dept. of Education, 830 First Street, N.E., 5th Floor – Lender Reporting, Washington, D.C. 20202.
Warning: Although the law does not explicitly state that this information be reported, such reporting is necessary to implement the required
monthly payments of the Consolidation Loan Rebate Fee (CLRF). Failure to report would be the basis for the initiation of an action to limit, suspend
or terminate the lender's participation in the Federal Family Education Loan Programs pursuant to 20 U.S.C. Sections 1080, 1082, 1085 and 1094.

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Also, any person who knowingly and willfully destroys or conceals any record relating to the provision of assistance under Title IV of the Higher
Education Act of 1965, as amended, or attempts to so destroy or conceal with intent to defraud the United States or to prevent the United States from
enforcing any right obtained by subrogation under Part B of Title IV, shall upon conviction thereof, be fined not more than $20,000 or imprisoned not
more than 5 years, or both, under the provisions of 20 U.S.C. 1097.

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