1845-0014 Rps

REPAYMENT PLAN REQUEST:

OMB No. 1845-0014
Form Under Review

Standard Repayment Plan/Extended Repayment Plan/Graduated Repayment Plan

RPR

Exp. Date xx/xx/xxxx

William D. Ford Federal Direct Loan (Direct Loan) Program

WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying document is
subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code and 20 U.S.C. 1097.
SECTION 1: BORROWER INFORMATION
Please enter or correct the following information.
Check this box if any of your information has changed.
SSN
Name
Address
City

State

Zip Code

Telephone - Primary
Telephone - Alternate
Email (Optional)
SECTION 2: REPAYMENT PLAN REQUEST
1. Check the appropriate box, then go to Item 2 to select a repayment plan:
I want to repay ALL of my Direct Loans under the Standard, Graduated, or Extended repayment plan.
I want to repay only my Direct Loans that are NOT eligible for an income-driven repayment (IDR) plan (see below) under the Standard, Graduated,
or Extended repayment plan, and I will choose an IDR plan for my Direct Loans that are eligible for an IDR plan (see the Note below for information
on how to choose an IDR plan).
The IDR plans are the Revised Pay As You Earn (REPAYE) Plan, the Pay As You Earn (PAYE) Plan, the Income-Based Repayment (IBR) Plan, and the
Income-Contingent Repayment (ICR) Plan. The table below shows the Direct Loan types that are NOT eligible for IDR plans.
Loan Type
IDR Plan Eligibility
Direct Parent PLUS Loans
Not eligible for any IDR plan.
Direct Consolidation Loans made on or after July 1, 2006 that
Not eligible for REPAYE, PAYE, or IBR, but may be repaid
repaid Direct Parent PLUS Loans or Federal Parent PLUS Loans
under ICR.
Direct Consolidation Loans made before July 1, 2006 that repaid
Not eligible for any IDR plan.
Direct Parent PLUS Loans or Federal Parent PLUS Loans (these are
called "Direct PLUS Consolidation Loans")
Note: To select an IDR plan, visit StudentAid.gov/idr to complete the IDR Plan Request. Contact your servicer to learn more. To
obtain estimated payment amounts under all of the Direct Loan repayment plans (including IDR plans), visit
StudentAid.gov/loan-simulator/.
2. Check the box for the repayment plan that you wish to select to repay all or some of your Direct Loans as indicated in Item 1:
These plans are described in Section 5.
Standard

Graduated

Extended - Fixed Payments

Extended - Graduated Payments

SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION
• I understand that: (1) I must choose the same repayment plan for all of my Direct Loans unless I want to repay some of my loans under
one of the IDR plans and I have other loans that may not be repaid under those plans. In this case, I may select one of the IDR plans for
the loans that are eligible for those plans by submitting the IDR Request, and may use this form to select a different repayment plan for
the other loans. (2) If I am beginning repayment of my loans for the first time and I do not select a repayment plan, I will be placed on
the Standard Repayment Plan. (3) If I am delinquent in making payments under my current repayment plan at the time I request to
change to a different plan, my servicer may grant me a forbearance to cover any payments that are overdue at the time I enter the
repayment plan I selected in Section 2.
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Borrower Name

Borrower SSN

SECTION 3: BORROWER UNDERSTANDINGS, CERTIFICATIONS, AND AUTHORIZATION (CONTINUED)
• I certify that: (1) The information I have provided on this form is true and correct; (2) I have read and understand the terms and
conditions of the repayment plan that I requested in Section 2, as explained in Section 5; and (3) I will repay my loans according to the
terms of my promissory note and repayment schedule.
• I authorize the U.S. Department of Education (and its agents or 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.
Date
Borrower's Signature
SECTION 4: INSTRUCTIONS FOR COMPLETING THE FORM
Type or print using dark ink. Enter your signature date as month-day-year (mm-dd-yyyy). Use only numbers. Example: January 31, 2023 =
01-31-2023. If you need help completing this form, contact your federal loan servicer. If you want to apply for a repayment plan and your
Direct Loans are serviced by different federal loan servicers, you must submit a separate repayment plan request to each loan servicer.
Return the completed form and any required documentation to the address shown in Section 6.
SECTION 5: REPAYMENT PLAN DESCRIPTIONS
STANDARD REPAYMENT PLAN

EXTENDED REPAYMENT PLAN

Under this plan, you will pay a fixed amount each month over the
course of your maximum repayment period in an amount that will
ensure that your loan is fully repaid by the end of your repayment
period.
This plan may result in lower total interest paid when
compared to other plans. For Direct Subsidized Loans, Direct
Unsubsidized Loans, and Direct PLUS Loans, the maximum
repayment period is 10 years. For Direct Consolidation
Loans, the maximum repayment period ranges from 10 to
30 years, depending on loan debt.
GRADUATED REPAYMENT PLAN

You may choose this plan only if (1) you had no outstanding
balance on a Direct Loan on October 7, 1998 or on the date you
obtained a Direct Loan after that date, and (2) you owe more than
$30,000 in outstanding Direct Loans.

Under this plan, your payments start out low and then increase
every two years. No single payment under this plan will be more
than three times greater than any other payment. Your scheduled
payment amount will ensure that your loan is fully repaid by the
end of your repayment period. Generally, the amount you will
repay over the life of your loan will be higher under this plan than
under the Standard Repayment Plan. This plan may be beneficial
if your income is low now but is likely to steadily increase. For Direct
Subsidized Loans, Direct Unsubsidized Loans, and Direct PLUS
Loans, the maximum repayment period is 10 years. For Direct
Consolidation Loans, the maximum repayment period ranges
from 10 to 30 years, depending on loan debt.

Under this plan, you have the option of making either fixed or
graduated payments over your maximum repayment period. Your
scheduled payment amount will ensure that your loan is fully repaid
by the end of your repayment period. If you choose graduated
payments, your payments start out low and then increase every two
years.
Under either the fixed or graduated monthly payment option, the
Extended Repayment Plan will give you a lower monthly payment on
your non-consolidation loans than the Standard or Graduated
Repayment Plans. However, because of the longer repayment period,
you will pay more interest over the life of your loans.
For all loan types, the maximum repayment period is 25 years.

SECTION 6: WHERE TO SEND THE COMPLETED FORM
Return the completed form and any required documentation to: (If no
address is shown, return to your loan servicer.)

If you need help completing this form call:
(If no telephone number is shown, call your loan servicer.)

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SECTION 7: IMPORTANT NOTICES
Privacy Act Notice. The Privacy Act of 1974 (5 USC 552a) requires
that the following notice be provided to you:
The authority for collecting the requested information from and
about you is §421 et seq., §451 et seq., and/or §461 et seq. of
the Higher Education Act (HEA) of 1965, as amended (20 USC
1071 et seq., 20 USC 1087a et seq., and/or 20 USC 1087aa et
seq.), and the authorities for collecting and using your Social
Security Number (SSN) are §484(a)(4) of the HEA (20 USC
1091(a)(4)) and 31 USC 7701(b). Participating in the Federal Family
Education Loan (FFEL) Program, William D. Ford Federal Direct
Loan (Direct Loan) Program, and Federal Perkins Loan (Perkins)
Program and giving us your SSN are voluntary, but you must
provide the requested information, including your SSN, to
participate.
The principal purposes for collecting the information on this form,
including your SSN, are to verify your identity, to determine your
eligibility to receive a loan or a benefit on a loan (such as a
deferment, forbearance, discharge, or forgiveness) under the FFEL
Program, Direct Loan Program, and/or Perkins Program, to permit
the servicing of your loan(s), and, if it becomes necessary, to locate
you and to collect and report on your loan(s) if your loan(s)
become delinquent or in default. We also use your SSN as an
account identifier and to permit you to access your account
information electronically.
The information in your file may be disclosed, on a case-by- case
basis or under a computer matching program, to third parties as
authorized under routine uses in the appropriate systems of
records notices. The routine uses of this information include, but
are not limited to, its disclosure to federal, state, or local agencies,
to private parties such as relatives, present and former employers,
business and personal associates, to consumer reporting
agencies, to financial and educational institutions, and to
guaranty agencies in order to verify your identity, to determine
your eligibility to receive a loan or a benefit on a loan, to permit
the servicing or collection of your loan(s), to enforce the terms of
the loan(s), to investigate possible fraud and to verify compliance
with federal student financial aid program regulations, or to locate
you if you become delinquent in your loan payments or if you
default. To provide default rate calculations, disclosures may be
made to guaranty agencies, to financial and educational
institutions, or to state agencies. To provide financial aid history
information, disclosures may be made to educational institutions.

To assist program administrators with tracking refunds and
cancellations, disclosures may be made to guaranty agencies, to
financial and educational institutions, or to federal or state agencies.
To provide a standardized method for educational institutions to
efficiently submit student enrollment status, disclosures may be
made to guaranty agencies or to financial and educational
institutions. To counsel you in repayment efforts, disclosures may be
made to guaranty agencies, to financial and educational
institutions, or to federal, state, or local agencies.
In the event of litigation, we may send records to the Department
of Justice, a court, adjudicative body, counsel, party, or witness if the
disclosure is relevant and necessary to the litigation. If this
information, either alone or with other information, indicates a
potential violation of law, we may send it to the appropriate
authority for action. We may send information to members of
Congress if you ask them to help you with federal student aid
questions. In circumstances involving employment complaints,
grievances, or disciplinary actions, we may disclose relevant records
to adjudicate or investigate the issues. If provided for by a
collective bargaining agreement, we may disclose records to a
labor organization recognized under 5 USC Chapter 71.
Disclosures may be made to our contractors for the purpose of
performing any programmatic function that requires disclosure of
records. Before making any such disclosure, we will require the
contractor to maintain Privacy Act safeguards. Disclosures may also
be made to qualified researchers under Privacy Act safeguards.
Paperwork Reduction Notice. 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 1845-0014. Public reporting burden for
this collection of information is estimated to average 10 minutes
per response, including time for reviewing instructions,
searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of
information.
The obligation to respond to this collection required to obtain or
retain a benefit (34 CFR 685.208). If you have comments or
concerns regarding the status of your individual submission of this
form, please contact your loan holder directly (see Section 6).

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