"Application for Borrower Defense to Loan Repayment"

Application for Borrower Defense to Loan Repayment is a 9-page legal document that was released by the U.S. Department of Education on June 1, 2020 and used nation-wide.

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OMB Number: 1845-0146
U.S. DEPARTMENT OF EDUCATION
Expiration Date: 06/30/2023
APPLICATION FOR BORROWER DEFENSE
TO LOAN REPAYMENT
If your school misled you or engaged in other misconduct, you may be eligible for “borrower defense to repayment,”
which is the forgiveness of some or all of your federal student loan debt.
FORM INSTRUCTIONS: To apply, you must complete, sign, and submit this form to the U.S. Department of Education
for review.
You may attach additional documents, such as transcripts, enrollment agreements, and promotional materials from your
school. Once completed, please submit this form and any additional documents you believe will help us review your
application by email to
or mail to US Department of Education - Borrower Defense to
BorrowerDefense@ed.gov
Repayment, PO Box 1854, Monticello, KY 42633.
Fields marked with an asterisk (*) are required for your application to be considered complete.
SECTION I: BORROWER INFORMATION
Please provide contact information for the borrower:
*Date of Birth (mm/dd/yyyy)
*Social Security Number
*Name (First, Middle, Last)
(Last 4 Digits)
*Telephone Number *Email Address
*State
*Zipcode
*Street Address
*City
*Are you a PARENT who took out a federal loan on behalf of the student?
Yes
No
*If yes, please enter the full name of the student (Last, First, Middle):
*If yes, please enter the student's Social Security Number (last 4 digits):
SECTION II: SCHOOL INFORMATION
*School
Campus (including on-line campuses for distance education borrowers)
*Location (City, State)
* Enrollment Dates at this school:
*From (month/year):
*To (month/year):
If you are still attending this school/campus, please indicate by checking the box.
Check if the enrollment dates above are approximate, or if you are unsure of them.
(06/20)
Page 1 of 9
EF
PSC Publishing Services (301) 443-6740
OMB Number: 1845-0146
U.S. DEPARTMENT OF EDUCATION
Expiration Date: 06/30/2023
APPLICATION FOR BORROWER DEFENSE
TO LOAN REPAYMENT
If your school misled you or engaged in other misconduct, you may be eligible for “borrower defense to repayment,”
which is the forgiveness of some or all of your federal student loan debt.
FORM INSTRUCTIONS: To apply, you must complete, sign, and submit this form to the U.S. Department of Education
for review.
You may attach additional documents, such as transcripts, enrollment agreements, and promotional materials from your
school. Once completed, please submit this form and any additional documents you believe will help us review your
application by email to
or mail to US Department of Education - Borrower Defense to
BorrowerDefense@ed.gov
Repayment, PO Box 1854, Monticello, KY 42633.
Fields marked with an asterisk (*) are required for your application to be considered complete.
SECTION I: BORROWER INFORMATION
Please provide contact information for the borrower:
*Date of Birth (mm/dd/yyyy)
*Social Security Number
*Name (First, Middle, Last)
(Last 4 Digits)
*Telephone Number *Email Address
*State
*Zipcode
*Street Address
*City
*Are you a PARENT who took out a federal loan on behalf of the student?
Yes
No
*If yes, please enter the full name of the student (Last, First, Middle):
*If yes, please enter the student's Social Security Number (last 4 digits):
SECTION II: SCHOOL INFORMATION
*School
Campus (including on-line campuses for distance education borrowers)
*Location (City, State)
* Enrollment Dates at this school:
*From (month/year):
*To (month/year):
If you are still attending this school/campus, please indicate by checking the box.
Check if the enrollment dates above are approximate, or if you are unsure of them.
(06/20)
Page 1 of 9
EF
PSC Publishing Services (301) 443-6740
If your attendance at the school listed above was not or has not been continuous (for example, from October 2015 to
March 2016, then again from August 2016 to November 2016), please describe all dates that you attended.
*Program Name or Major (e.g. Nursing, Medical Assistant, Paralegal).
Credential/Degree Sought (e.g. Certificate, Diploma, Associates, Bachelors, Masters).
If you enrolled in multiple programs at the school listed above, please describe all programs that you were enrolled in.
*Current Status at school listed above
Graduated
Transferred Out
Withdrew
Attending
SECTION III: OTHER LOAN REDUCTION OR TUITION RECOVERY REQUESTS
*Have you made any other requests to have your Federal loans forgiven (for example, under a closed school discharge
or false certification discharge from the U.S. Department of Education)?
Yes
No
*If yes, please describe these other request(s), including the amount of any loan forgiveness that you received, and
attach any documentation about the requests, if available.
*Have you made any requests to anyone else to recover tuition amounts that you paid to your school (for example, a
lawsuit against the school or a claim made to a tuition recovery program)?
Yes
No
*If yes, please describe these other request(s), including the amount of the payment that you received (if any), and
attach any documentation about the requests, if available.
SECTION IV. BASIS FOR BORROWER DEFENSE
Answer the questions for each section below that applies to you.
For each section below that applies to you, please provide a detailed description of why you believe you are entitled to
borrower defense, including the following information:
1.
How the school communicated with you, whether in a brochure, online, over the phone, by email, or in person
2. The name/title of people who you believe misled you (if known)
3.
What the school told you or failed to tell you.
4. Why you believe you were misled.
Attach any related documents, such as transcripts, enrollment agreements, promotional materials from the school, emails
with school officials or your school's manual, or course catalog.
Note: You only need to provide information for the sections below that apply to you, but you must complete at
least one section. If you are a Parent PLUS borrower, the word “you” in the following sections also refers to the
student.
If you need more space to complete any section, please attach additional pages to your application.
(06/20)
Page 2 of 9
EMPLOYMENT PROSPECTS
Did the school mislead you (or fail to tell you important information) about promises of future employment, likelihood of
finding a job, eligibility for certification or licensure in your field of study, how many students graduate, and/or earnings
after graduation?
Yes
No
If yes, you must provide detailed information about how the school misled you. Please also describe any financial harm
to you as a result of the school's conduct.
*Did you choose to enroll in your school based in part on the issues you describe above?
Yes
No
PROGRAM COST AND NATURE OF LOAN
Did the school mislead you (or fail to tell you important information) about how much your classes would cost, how you
would pay for your education, the terms of loan repayment, and/or other issues about the cost of your education?
Yes
No
If yes, you must provide detailed information about how the school misled you. Please also describe any financial harm
to you as a result of the school's conduct.
*Did you choose to enroll in your school based in part on the issues you describe above?
Yes
No
(06/20)
Page 3 of 9
TRANSFERRING CREDITS
Did the school mislead you (or fail to tell you important information) about transferring your credits from this school to
other schools?
Yes
No
If yes, you must provide detailed information about how the school misled you. Please also describe any financial harm
to you as a result of the school's conduct.
*Did you choose to enroll in your school based in part on the issues you describe above?
Yes
No
CAREER SERVICES
Did the school mislead you (or fail to tell you important information) about the availability or quality of job placement,
career services assistance, or the school's connections to employers within your field of study?
Yes
No
If yes, you must provide detailed information about how the school misled you. Please also describe any financial harm
to you as a result of the school's conduct.
*Did you choose to enroll in your school based in part on the issues you describe above?
Yes
No
(06/20)
Page 4 of 9
EDUCATIONAL SERVICES
Did the school mislead you (or fail to tell you important information) about educational services, such as the availability of
externships, qualifications of teachers, instructional methods, or other types of educational services?
Yes
No
If yes, you must provide detailed information about how the school misled you. Please also describe any financial harm
to you as a result of the school's conduct.
*Did you choose to enroll in your school based in part on the issues you describe above?
Yes
No
ADMISSIONS AND URGENCY TO ENROLL
Did the school mislead you (or fail to tell you important information) about the importance of enrolling immediately, the
consequences of failure to enroll, how difficult it was to be admitted, or anything else about the admission process?
Yes
No
If yes, you must provide detailed information about how the school misled you. Please also describe any financial harm
to you as a result of the school's conduct.
*Did you choose to enroll in your school based in part on the issues you describe above?
Yes
No
(06/20)
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