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   Sallie Mae                                                           Email Address: _________________________________
   Department of Education Loan Services                                Name: ________________________________________
   P.O. Box 9635                                                        Address: _______________________________________
   Wilkes-Barre, PA 18773-9635                                          City/State/Zip__________________________________
   1-800-722-1300                                                       Telephone – Home: ______________________________
                                                                        Telephone – Other: ______________________________

Terms and Conditions                                                    Account Number: ________________________________

Before considering forbearance, make sure you’ve explored any deferments for which you may be eligible. Deferments may cost less
than forbearance over the life of the loan. Learn more by logging in to your account at

Forbearance is the temporary postponement of your education loan payments. It’s important to note that forbearance is not an
entitlement, but rather an agreement between you and your lender.

Before you consider forbearance to temporarily postpone your federal student loan payments, here are some things to keep in mind:

    •    Forbearance should be considered a last resort. Use of forbearance increases your total loan cost.

    •    You are responsible for the interest that accrues. Any unpaid interest may be capitalized (added to your principal balance)
         at the end of the forbearance period. You can avoid capitalization by paying the interest as it accrues, even though no
         payments are due during the forbearance period.

This forbearance request form applies to your Federal Family Education Loan Program (FFELP) and William D. Ford Direct Loans
(known as DL loans) education loan(s) that is serviced by Sallie Mae – Department of Education Loan Services. This form may also
be used if you have any FFELP loans serviced by Sallie Mae.

It’s important to note that Sallie Mae-owned FFELP loans will capitalize interest as often as quarterly and at the end of the

If you’re enrolled in automatic debit, your completed forbearance request form must be received at least 15 days before your
payment due date, otherwise your payment will be withdrawn as scheduled. Please note the servicer has the right to remove or shorten
the forbearance if the agreed-upon terms of your forbearance are not met.

If your loan(s) is past due and your delinquency has been reported to the consumer reporting agencies, please note that information
reported before your forbearance is processed will not be retracted.

It’s important to note that forbearance may affect any borrower benefit or repayment incentives applicable to your federal student
loan(s), such as on-time payment incentives.

To apply for forbearance, simply complete this form and fax it to 866-266-0178 or mail it to:

         Sallie Mae – Department of Education Loan Services
         P.O. Box 9635
         Wilkes-Barre, PA 18773-9635

You’ll be notified of the decision, whether your request has been approved or denied.

Questions? You’re welcome to visit us online at, or call us toll free at 800-722-1300. We’re here to help you
Monday - Thursday 8 a.m. to 9 p.m., and Friday 8 a.m. to 8 p.m., ET.



I’m temporarily experiencing financial hardship and am unable to make the monthly payments due under my repayment schedule on
my FFELP and/or DL loan(s) that is serviced by Sallie Mae – Department of Education Loan Services, as well as my FFELP loan(s)
that is serviced by Sallie Mae. I intend to repay my loan(s) and I agree to resume making my full monthly principal and interest
payments at the conclusion of the forbearance period.

I request forbearance of amounts due on this loan(s) for a                         month period. I understand that I can only request
forbearance for up to 12 months into the future. I understand that my servicer will use administrative forbearance to cover any past
due amount when my forbearance request is processed and that this administrative forbearance is not counted against this 12-month

I understand interest may capitalize as described above, and that capitalization of interest may affect my repayment terms and the
total amount I pay back.

I agree to the terms of this forbearance and agree to repay my federal loan(s) upon expiration of this forbearance and in accordance
with the terms of my Promissory Note(s). If I have a Spousal Consolidation Loan or co-made PLUS loan, both borrowers must be
experiencing financial hardship.

By providing my telephone number, I authorize Sallie Mae, Inc., its related companies and anyone calling on their behalf to contact
me at such number using any means of communication, including, but not limited to, calls placed to my cellular phone using an
auto-dialer and calls using artificial or prerecorded messages and/or text messages, regarding this inquiry, application and any
current or future accounts owned or serviced by or on behalf of Sallie Mae, Inc. and its related companies, even if I will be charged
by my service provider(s) for receiving such communications.

_______________________________________                                 _________________
Borrower Signature                                                      Date

_______________________________________                                 _________________
Co-borrower Signature                                                   Date

Office Use Only

Sallie Mae believes, based on the statement above and/or other communications recorded in the account history, that the
borrower does intend to repay the loan(s) but is currently unable to make scheduled loan payments.


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