FEDERAL PERKINS STUDENT LOANS MADE AFTER JULY, 1993
REQUEST FOR UNEMPLOYMENT DEFERMENT
Address _______________________________City & State_________________________________
Email Address: _____________________________________Cell Phone# ( )_______________
You must attach proof of registration with the employment office, proof of your unemployment benefits
and rejection letters from prospective employers, (If you do not have rejection letters give at least two (2)
places you have given employment applications). All Correspondence should be mailed to: UTC/Bursar’s
Office Dept 6005, 615 McCallie Ave., Chattanooga, TN 37403
Company Name___________________________ Company Name____________________________
Phone#( )______________________________ Phone#( )________________________________
PLEASE READ CAREFULLY AND SIGN BELOW:
I understand that all information and supporting documents will be held in confidence and will not be subject
to dissemination outside the requirements of the University of Tennessee at Chattanooga (UTC).
I understand that interest will not accrue while I am in an unemployment deferment. I also, understand that I
must be actively looking for a job to qualify and continue to qualify for an unemployment deferment and an
Unemployment Contact Form should be completed each month and mailed to our office.
I certify that all information included with this request is true and correct. I authorize (UTC) to make
whatever inquires necessary in connection with the review of information concerning my ability to repay.
I HEREBY REQUEST AN UNEMPLOYMENT DEFERMENT ON MY FEDERAL PERKINS
STUDENT LOAN. I CERTIFY THAT I UNDERSTAND AND AGREE TO ALL THE TERMS AND
CONDITIONS THAT APPLY TO THIS REQUEST.
________________________________________ ____________________________ _________________
Signature SSN Date
FOR UTC STUDENT LOAN DEPARTMENT USE ONLY:
__Approved From ____________________ to______________________ __Disapproved
Signature of Authorizing Official Date