Borrower Defense Loan and Financial Impact Worksheet

BORROWER DEFENSE LOAN AND FINANCIAL IMPACT WORKSHEET

Use this worksheet to organize loan history, financial harm, and evidence before completing the current official Federal Student Aid Borrower Defense to Repayment application. Do not submit this worksheet as a substitute for the official form.

SECTION 1: APPLICANT INFORMATION

Full Legal Name: _______________________________________________

Date of Birth: _______________________________________________

Social Security Number (Last 4 Digits): XXX-XX-____________

Current Mailing Address:
_______________________________________________
_______________________________________________
City: _________________ State: _______ ZIP: ___________

Phone Number: _______________________________________________

Email Address: _______________________________________________

Federal Student Aid ID (FSA ID): _______________________________________________

SECTION 2: LOAN INFORMATION

Loan Servicer Name: _______________________________________________

Account Number(s): _______________________________________________

Total Outstanding Balance (Approximate): $_______________

Loan Types (Check all that apply and confirm in StudentAid.gov):

☐ Direct Subsidized Loans
☐ Direct Unsubsidized Loans
☐ Direct PLUS Loans (Graduate/Professional)
☐ Direct PLUS Loans (Parent)
☐ Direct Consolidation Loans
☐ FFEL Program Loans
☐ Federal Perkins Loans

The current official application covers the Direct Loan, FFEL, and Perkins Loan programs. Do not assume an FFEL or Perkins Loan must be consolidated before an application can be submitted. Record each loan's type, disbursement date, and consolidation history, because the Department states that it evaluates a consolidated loan using its consolidation date. Private loans are outside the federal application.

Applicable Federal Rule Period

The current official application states that, in general, loans taken out or consolidated:

1. On or before June 30, 2017, are evaluated under 34 C.F.R. § 685.206(c).
2. From July 1, 2017, through June 30, 2020, are evaluated under 34 C.F.R. § 685.222(a).
3. On or after July 1, 2020, are evaluated under 34 C.F.R. § 685.206(e).

Different loans in one submission may be reviewed under different rules. Do not use one generic test for misconduct, reliance, causation, harm, limitation periods, or relief.

SECTION 3: SCHOOL INFORMATION

Name of School: _______________________________________________

Campus Location (City/State): _______________________________________________

Program of Study: _______________________________________________

Dates of Enrollment:

• Start Date: _______________________________________________
• End Date/Withdrawal Date: _______________________________________________

Did you complete the program?
☐ Yes
☐ No - Date of Withdrawal: _______________________________________________

Credential Received (if applicable):
☐ Certificate
☐ Associate's Degree
☐ Bachelor's Degree
☐ Master's Degree
☐ Doctorate/Professional Degree
☐ Did not receive credential

SECTION 4: POSSIBLE CLAIM SUBJECTS

Use the current official form to identify and answer every applicable claim section. The subjects below are an organizing aid, not an independent statement that a claim qualifies under every rule period.

A. Misrepresentation by the School

☐ Job Placement Rates - The school misrepresented graduate employment statistics
☐ Salary Expectations - The school misrepresented expected salaries after graduation
☐ Accreditation Status - The school misrepresented its accreditation status
☐ Transferability of Credits - The school misrepresented credit transfer options
☐ Program Quality/Content - The school misrepresented the nature or quality of instruction
☐ Cost of Attendance - The school misrepresented total costs or financial aid terms
☐ Licensing/Certification - The school misrepresented licensure or certification outcomes
☐ Affiliation with Employers - The school falsely claimed employer partnerships

B. Breach of Contract

☐ The school failed to provide services, programs, or equipment promised in enrollment agreements
☐ The school significantly changed the program without notice
☐ The school failed to provide qualified instructors as promised

C. Other Misconduct

☐ Unfair or deceptive practices
☐ Violation of state consumer protection laws
☐ Other: _______________________________________________

SECTION 5: DETAILED STATEMENT OF CLAIM

Describe in detail what the school told you or did that you believe was false, misleading, or illegal. Include:

• What specific statements were made
• Who made the statements (recruiter, admissions officer, instructor, etc.)
• When the statements were made (approximate dates)
• How the statements were communicated (in person, writing, website, advertising)
• How the statements influenced your decision to enroll or borrow

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
(Attach additional pages if necessary)

SECTION 6: EVIDENCE AND DOCUMENTATION

Check all documentation you are providing with this application:

☐ Enrollment agreement/contract
☐ School catalog or brochure
☐ Promotional materials or advertisements
☐ Website screenshots (with dates if possible)
☐ Emails or written communications from school officials
☐ Notes from conversations with school representatives
☐ Witness statements from other students
☐ Academic transcripts
☐ Loan documents
☐ News articles about the school
☐ Government enforcement actions against the school
☐ State attorney general complaints or actions
☐ Accreditation notices or warnings
☐ Other: _______________________________________________

SECTION 7: FINANCIAL HARM

Describe the financial harm you suffered as a result of the school's conduct:

Total Amount Borrowed for This School: $_______________

Payments Already Made: $_______________

Current Outstanding Balance: $_______________

Did you complete your education at another institution?
☐ Yes - Institution: _______________________________________________ Cost: $_______________
☐ No

Employment Impact:
☐ Unable to find employment in field of study
☐ Employed but at significantly lower salary than represented
☐ Had to obtain additional education/training at personal expense
☐ Other: _______________________________________________

SECTION 8: PRIOR APPLICATIONS AND LEGAL ACTIONS

Have you previously submitted a borrower defense claim?
☐ Yes - Date: _______________ Claim Number (if known): _______________
☐ No

Have you participated in any lawsuit or legal action against this school?
☐ Yes - Please describe: _______________________________________________
☐ No

Are you aware of any government enforcement action against this school?
☐ Yes - Please describe: _______________________________________________
☐ No

SECTION 9: AMOUNTS AND OUTCOME TO TRACK

Record the amounts affected and the outcome sought. Available relief depends on the governing rule and the Department's determination; this checklist does not create an entitlement.

☐ Full discharge of all loans related to this school
☐ Partial discharge of loans (specify amount or percentage): _______________________________________________
☐ Refund of payments already made on these loans
☐ Removal of negative credit reporting related to these loans
☐ Discharge of any amounts in collections
☐ Other outcome identified in the official application or governing decision: ______________________

SECTION 10: CURRENT REPAYMENT STATUS

What is your current loan status?
☐ In Repayment
☐ In Forbearance
☐ In Deferment
☐ In Default
☐ Wage Garnishment Active
☐ Treasury Offset (Tax Refund Seizure) Active

The current paper application states that, when the Department receives an application, nondefaulted loans will be put into forbearance and defaulted loans will be put into stopped-collections status unless the borrower requests otherwise. It also states that the Department will ask holders of non-Department-held FFEL loans to make the same changes. Read the official form, select the intended treatment, and verify implementation with the servicer or holder.

☐ I wish to have the covered loans placed into forbearance or stopped-collections status
☐ I do not wish to have the covered loans placed into forbearance or stopped-collections status

The official form warns that the amount owed may be higher if the application is denied and directs borrowers who wish to make interest payments during forbearance or stopped collections to contact their servicer.

GOVERNING-LAW AND SCHOOL-SPECIFIC CHECK

For loans governed by the pre-July 1, 2017 standard, the official application states that the Department considers whether the borrower would have a cause of action under applicable state law. Identify the state or states where the borrower lived during enrollment and obtain state-specific legal review. For every loan period, check current official Federal Student Aid notices and official government or court materials concerning the particular school, campus, program, and attendance dates. An old school list, settlement, investigation, or group-discharge announcement does not by itself establish this borrower's eligibility.

OFFICIAL CERTIFICATION

This worksheet is not the official application and should not be signed as though it were. Transfer the relevant information to the current Federal Student Aid application, read its full certification and assignment language, and sign only after confirming that the submission is true and complete. The official form states that a knowingly false statement or misrepresentation may result in criminal penalties.

SUBMISSION INSTRUCTIONS

Online Submission (Preferred):

1. Log in to StudentAid.gov
2. Navigate to the Borrower Defense Application portal
3. Complete the online form and upload supporting documents

Current Paper Form:

Confirm that the PDF has not been replaced and use the address printed on it. The form current on July 18, 2026 (OMB No. 1845-0163; expiration July 31, 2026) lists:

U.S. Department of Education
Federal Student Aid Information Center
P.O. Box 1854
Monticello, KY 42633

IMPORTANT LEGAL NOTICES

Regulatory Status: The Fifth Circuit ordered a preliminary injunction and postponement of the challenged borrower-defense and closed-school provisions of the 2022 rule pending final judgment in Career Colleges & Schools of Texas v. U.S. Department of Education, No. 23-50491 (5th Cir. Apr. 4, 2024). The current official application continues to use the three date-based rule periods above.

Timing and Limitation Rules: The official form warns that adjudication may take years. Separate limitation rules may govern particular loan periods, claim types, or recovery of amounts already collected. Do not rely on a generic statement that every borrower-defense claim has no limitation period.

Consolidation Note: List all FFEL and Perkins Loans and their consolidation history on the current application. Do not treat consolidation as a universal prerequisite to submitting the application.

CHECKLIST BEFORE SUBMISSION

☐ Completed all required sections of the official application
☐ Read and signed the certification in the official application
☐ Attached all supporting documentation
☐ Made copies of everything for your records
☐ Confirmed correct mailing address or online submission method
☐ Noted any response deadlines or follow-up requirements

OFFICIAL SOURCES

• Federal Student Aid Borrower Defense page
• Official Borrower Defense Application
• 20 U.S.C. § 1087e
• 34 C.F.R. Part 685
• Fifth Circuit opinion, No. 23-50491

This worksheet was last verified on July 18, 2026. Confirm that the official form and instructions remain current before use.