Forms

There are several types of forms available to you during the repayment of your student loans. Please print your form and return it to the mailing address shown below. As always, if you have any questions or need assistance completing your form, please call in and speak with a customer service representative.

Utah Higher Education Assistance Authority
P.O. Box 145110
Salt Lake City, UT 84114-5110

FFELP

Name
Authorization to Release Information to a Third Party

3rd party authorization. Authorization to release information to a third party.

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Automatic Payment - Direct Debit Request Form

When applying for Automatic Payments, please print two copies of the form. Complete both of them, save one for your records, and send the other to us at the address below. Once we receive the completed form, we will notify you of the date your first automatic payments will be deducted.

UHEAA
P O Box 145111
Salt Lake City, UT 84114-5111

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Economic Hardship Deferment Request

FFELP HRD Deferment Form with 2018 Poverty Guidelines

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General Forbearance Request

FFEL General Forbearance Request Form

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Graduate Fellowship Deferment

This form is used if you have Direct, FFELP or Perkins loans. Complete this form if you are participating in a Graduate Fellowship program and need to postpone the repayment of your loans. Before completing this form, read it carefully. As the borrower, you need to complete Sections 1, 2, and 3 of this form. After you complete the first three portions of the form, an authorized official must complete Section 4 to certify your participation in a Graduate Fellowship program.

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In-School Deferment Request

FFEL In-School Deferment Request Form

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Income-Driven Repayment Plan Request

Income-Driven Repayment Plan Request

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Income-Sensitive Repayment Request Form

UHEAA Income Sensitive Repayment Request Form

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Loan Discharge Application: False Certification Ability to Benefit

The borrower’s ability to benefit was falsely certified by the school.

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Loan Discharge Application: False Certification Disqualifying Status

The borrower had a disqualifying status at the time their loans were originated or certified.

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Loan Discharge Application: False Certification Unauthorized Signature

There was an unauthorized signature or payment by the school.

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Loan Discharge Application: School Closure

Student unable to complete his/her program of study because the school closed.

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Loan Discharge Application: Unpaid Refund

You may be eligible for a discharge of your Direct Loan or FFEL Program loan if you withdrew from school, but the school didn’t pay a refund that it owed to the U.S. Department of Education or to the lender, as appropriate. Check with the school to see how refund policies apply to federal aid at the school.

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Mandatory Forbearance Request

Medical and Dental Internship/Residency, National Guard Duty or Department of Defense Loan Repayment Program.

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Mandatory Forbearance Request Student Loan Debt Burden

The total monthly loan payment on all eligible federal education loans is equal to or greater than 20% of borrower’s total monthly income.

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Military Deferment Request

MIL Deferment Request: Military Service Deferment / Post-Active Duty Student Deferment Request

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Parent PLUS Borrower Deferment Request

Parent PLUS Borrower Deferment Request Form

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Rehabilitation Training Deferment

This form is used if you have Direct, FFELP or Perkins loans. Complete this form if you are requesting to postpone payment of your loans while you participate in a Rehabilitation Training program.

Before completing this form, read it carefully. As the borrower, you need to complete Sections 1, 2, and 3 of this form. After you complete the first three sections of the form, an authorized official must complete Section 4 to certify that you are participating in a Rehabilitation Training program.

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Teacher Loan Forgiveness Forbearance Request

TTLF Forbearance Deferment Request Form

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Teacher Loan Forgiveness Request

TLFF Teacher Loan Forgiveness Request Form

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Temporary Total Disability Deferment Request (FFELP Pre 1993)

Temporary Total Disability Deferment Request Form (FFELP Pre 1993)

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Total and Permanent Disability Discharge

Please visit www.disabilitydischarge.com for more information about Total and Permanent Disability Discharge.

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Unemployment Deferment Request

Unemployment Deferment Request Form

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TILP

Name
Economic Hardship Deferment Request

TILP Economic Hardship Deferment Request

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In-School Deferment Request

TILP In-School Deferment Request Form

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Military Deferment Request

TILP Military Deferment Request Form

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Unemployment Deferment Request

TILP Unemployment Deferment Request Form

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Defaulted Loan

Name
Alternate Documentation of Income for the 15% Formula

This form will be used for borrowers to document their income for the 15% formula if their taxes have not been filed or if they have had a change to their adjusted gross income since their last tax filing.

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Compromise Evaluation Questionnaire

Questionnaire to evaluate a compromise payment plan.

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Direct Payment Authorization Form

Automatic Payment - Direct Debit Request Form close When applying for Automatic Payments, please print two copies of the form. Complete both of them, save one for your records, and send the other to us at the address below. Once we receive the completed form, we will notify you of the date your first automatic payments will be deducted. UHEAA P O Box 145111 Salt Lake City, UT 84114-5111

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Family Budget Statement

Family Budget Statement (FBS) for review of current financial circumstance.

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Loan Rehabilitation: Income and Expense Information

This form is used when a borrower is seeking to rehabilitate his or her defaulted loan, but objects to the monthly payment calculated under the 15% Formula.

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Online Forms

Name Form Type
AutoPay Form for Defaulted Loans Defaulted Loans