Reply to Ecsi

							                  TEACHER INCENTIVE LOAN FOR MATHEMATICS & SCIENCE
                             OVERDUE LOAN OPTIONS FORM

                                          BORROWER DETAIL
Name:                                                    Loan No(s).
Address:                                                 Home Phone:
City/State/Zip:                                          Work Phone:
Soc. Sec. #:                                             E-mail:
                                                         Fax:

                                CURRENT STATUS (check as many as apply)
       Teaching       School:
                      Address:
                      Principal:
                           NOTE: Completion of this form will not substitute for the regular cancellation form.
       Substituting (Submit appropriate documentation)
       Seeking to obtain a full –time teaching position
       Unemployed
       Employed outside of teaching       Employer:
                                          Address:
                                          City/State/Zip:
       Other (Explain):


                                    REQUESTED ACTION (check one)
I wish to request a:
        Deferment (Complete the deferment form with specified dates. Note unemployment deferral extension
        to 24 months.)
        Temporary reduced payment schedule (attached suggested payment scale)
        Forbearance (attach letter of explanation of circumstances)

                                              ECSI RECORDS
ECSI records:
      Are inaccurate and I am not in overdue status (attach explanation of the problem with ECSI records)
      Should now be up to date. I sent a: (check one)
                     Cancellation form
                     Deferment form
                     Payment
      to ECSI on            (insert date)                       to: (check one)
                     Clear
                     Reduce
      my overdue status.

Use this space for additional comments, questions, problems:




Return to: Math/Science Teacher Loan Program, Washington Student Achievement Council, 917 Lakeridge
Way, PO Box 43430, Olympia, Washington 98504-3430.