STUDENT LOAN DISCHARGE APPLICATION - GENERAL

OVERVIEW OF DISCHARGE TYPES

Student loan discharge releases you from your obligation to repay some or all of your federal student loans. This general application guide covers multiple discharge types. Use this form to determine which discharge type applies to your situation.

SECTION 1: APPLICANT INFORMATION

Full Legal Name: _______________________________________________

Former Names (if any): _______________________________________________

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

Current Loan Servicer: _______________________________________________

Account Number: _______________________________________________

Total Outstanding Balance: $_______________

Loan Types (Check all that apply):

☐ Direct Subsidized Loans
☐ Direct Unsubsidized Loans
☐ Direct PLUS Loans (Graduate/Professional)
☐ Direct PLUS Loans (Parent)
☐ Direct Consolidation Loans
☐ FFEL Stafford Loans (Subsidized)
☐ FFEL Stafford Loans (Unsubsidized)
☐ FFEL PLUS Loans
☐ FFEL Consolidation Loans
☐ Federal Perkins Loans
☐ Federal Nursing Loans
☐ Health Professions Student Loans

Loan Status:
☐ In Repayment
☐ In Grace Period
☐ In Deferment
☐ In Forbearance
☐ In Default
☐ In Collections

SECTION 3: DISCHARGE TYPE SELECTION

Select the type of discharge you are applying for:

Category A: School-Related Discharges

☐ Borrower Defense to Repayment
- School engaged in misconduct (misrepresentation, fraud, breach of contract)
- See separate Borrower Defense Application Template

☐ Closed School Discharge
- School closed while enrolled or within 180 days of withdrawal
- See separate Closed School Discharge Application Template

☐ False Certification Discharge - Ability to Benefit
- Did not have high school diploma/GED and school did not properly test
- See separate False Certification Discharge Application Template

☐ False Certification Discharge - Disqualifying Status
- Had a condition that legally prevented employment in field of study

☐ False Certification Discharge - Unauthorized Signature/Payment
- School forged signature or obtained loan without authorization

☐ Unpaid Refund Discharge
- School owed you a refund but failed to pay it

Category B: Personal Circumstance Discharges

☐ Total and Permanent Disability (TPD) Discharge
- Unable to engage in substantial gainful activity due to disability
- See separate TPD Discharge Application Template

☐ Death Discharge
- Discharge of loans upon death of borrower or student (for Parent PLUS)

☐ Bankruptcy Discharge
- Discharge through bankruptcy proceedings (requires undue hardship determination)

Category C: Employment-Related Forgiveness

☐ Public Service Loan Forgiveness (PSLF)
- After 120 qualifying payments while employed full-time by qualifying employer
- See separate PSLF Guide Template

☐ Teacher Loan Forgiveness
- After 5 years of qualifying teaching service

☐ Perkins Loan Cancellation
- Various public service cancellation programs

Category D: Income-Driven Repayment Forgiveness

☐ IDR Forgiveness
- After 20-25 years of qualifying payments under an IDR plan

SECTION 4: SCHOOL-RELATED DISCHARGE DETAILS

Complete this section if applying for a school-related discharge

School Name: _______________________________________________

School Address: _______________________________________________

School OPE ID (if known): _______________________________________________

Dates of Attendance:
- Enrollment Date: _______________________________________________
- Last Date of Attendance: _______________________________________________

Program of Study: _______________________________________________

Credential Sought:
☐ Certificate/Diploma
☐ Associate's Degree
☐ Bachelor's Degree
☐ Master's Degree
☐ Doctorate/Professional Degree

Completion Status:
☐ Completed program
☐ Withdrew from program
☐ Was enrolled when school closed
☐ On approved leave of absence when school closed

SECTION 5: DISCHARGE ELIGIBILITY CHECKLIST

Closed School Discharge Eligibility:

☐ School closed while I was enrolled
☐ School closed within 180 days of my withdrawal
☐ I did not complete my program at the school
☐ I did not complete a comparable program through a teach-out agreement
☐ I have not transferred credits to a comparable program

False Certification (Ability to Benefit) Eligibility:

☐ I did not have a high school diploma or GED when I enrolled
☐ The school did not properly administer an ability-to-benefit test
☐ The school allowed me to retake the test until I passed
☐ The test was not independently administered

False Certification (Disqualifying Status) Eligibility:

☐ I had a physical or mental condition at enrollment
☐ This condition would prevent employment in my field of study
☐ The school knew or should have known about this condition
☐ I was not informed I would not be able to work in the field

Unpaid Refund Eligibility:

☐ I withdrew from the school
☐ The school owed me a refund under federal or state law
☐ The school did not pay the refund
☐ I have documentation of the unpaid refund amount

SECTION 6: DEATH DISCHARGE INFORMATION

Complete this section if applying for death discharge

Applicant's Relationship to Deceased:
☐ Surviving spouse
☐ Parent
☐ Child
☐ Personal representative/executor
☐ Other: _______________________________________________

Deceased's Full Legal Name: _______________________________________________

Date of Death: _______________________________________________

Required Documentation:
☐ Certified death certificate
☐ Proof of relationship (if applicable)
☐ Letters of administration (if personal representative)

SECTION 7: BANKRUPTCY DISCHARGE INFORMATION

Complete this section if applying for bankruptcy discharge

IMPORTANT: Federal student loans are generally not dischargeable in bankruptcy unless you can prove "undue hardship." This typically requires a separate adversary proceeding within your bankruptcy case.

Bankruptcy Case Information:

Court: _______________________________________________

Case Number: _______________________________________________

Chapter: ☐ 7 ☐ 13 ☐ Other: _______

Filing Date: _______________________________________________

Discharge Date (if applicable): _______________________________________________

Did you file an adversary proceeding for student loans?
☐ Yes - Case Number: _______________________________________________
☐ No

Did the bankruptcy court determine undue hardship?
☐ Yes - Date of determination: _______________________________________________
☐ No
☐ Pending

SECTION 8: DOCUMENTATION CHECKLIST

General Documentation (All Discharge Types):
☐ Government-issued photo ID
☐ Loan account statements
☐ Most recent billing statement

School-Related Discharges:
☐ Enrollment agreement/contract
☐ Academic transcripts
☐ Proof of attendance dates
☐ School closure notice (if applicable)
☐ Teach-out agreement refusal letter (if applicable)

False Certification (Ability to Benefit):
☐ Evidence of educational level at enrollment
☐ Test results (if available)
☐ School catalog from enrollment period

Death Discharge:
☐ Certified death certificate (original or certified copy)
☐ Proof of identity as authorized representative

Bankruptcy Discharge:
☐ Bankruptcy petition
☐ Discharge order
☐ Adversary proceeding judgment (if applicable)

SECTION 9: FORBEARANCE REQUEST DURING PROCESSING

Do you want to request forbearance while your discharge application is being processed?

☐ Yes, I request mandatory forbearance while my application is reviewed
☐ No, I will continue making payments

IMPORTANT: While forbearance stops required payments, interest may continue to accrue. If your discharge is denied, this interest may capitalize (be added to your principal balance).

SECTION 10: REFUND OF PRIOR PAYMENTS

If your discharge is approved, you may be entitled to a refund of payments made on the discharged loans.

☐ Yes, I request a refund of any payments I made on the loans being discharged

☐ Yes, I request a refund of any amounts collected through wage garnishment

☐ Yes, I request a refund of any tax refunds seized through Treasury offset

Provide details of involuntary collections:
_______________________________________________
_______________________________________________

STATE-SPECIFIC NOTES

California (CA)

• California has additional protections for students of closed schools
• DFPI maintains list of closed schools and assists with discharge applications
• California Student Aid Commission may provide resources
• State supplemental discharge programs may be available

Texas (TX)

• Texas Workforce Commission oversees career schools and colleges
• Texas Higher Education Coordinating Board handles complaints
• Contact Attorney General Consumer Protection Division for additional assistance

Florida (FL)

• Commission for Independent Education handles school closure issues
• Florida Student Assistance Grant recipients may have additional considerations
• Florida Office of Financial Regulation oversees servicer conduct

New York (NY)

• HESC provides discharge assistance for NY residents
• Attorney General has active student loan protection efforts
• NY State Education Department handles school licensing issues
• Additional state-level discharge programs may be available

SECTION 11: CERTIFICATION AND AUTHORIZATION

I certify that:

☐ All information provided in this application is true, complete, and accurate to the best of my knowledge

☐ I understand that providing false information may result in criminal prosecution under 18 U.S.C. 1001

☐ I authorize the U.S. Department of Education and my loan servicer to verify all information provided

☐ I authorize release of my educational records as necessary to process this application

☐ I understand that discharge is not guaranteed and depends on meeting eligibility requirements

☐ I understand that if my application is denied, I remain responsible for repaying my loans

☐ I understand that discharged amounts may be taxable income (except PSLF and certain other programs)

Applicant Signature: _______________________________________________

Date: _______________________________________________

Print Name: _______________________________________________

SUBMISSION INSTRUCTIONS

By Type of Discharge:

Closed School, False Certification, Unpaid Refund:
Submit to your loan servicer or:
- Online: StudentAid.gov
- Mail: [Servicer address]

Total and Permanent Disability:
- Online: StudentAid.gov/tpd-discharge
- Mail: U.S. Department of Education
TPD Discharge
P.O. Box 87130
Lincoln, NE 68501

Death Discharge:
Contact your loan servicer directly

Borrower Defense:
- Online: StudentAid.gov (Borrower Defense portal)
- Mail: U.S. Department of Education
Borrower Defense to Repayment
P.O. Box 1854
Monticello, KY 42633

PROCESSING TIMELINE EXPECTATIONS

AFTER SUBMISSION CHECKLIST

☐ Keep copies of all submitted documents
☐ Note the date of submission
☐ Request written confirmation of receipt
☐ Follow up if no response within 30 days
☐ Continue monitoring loan account status
☐ Respond promptly to any requests for additional information
☐ Know your appeal rights if denied

TAX IMPLICATIONS

Federal Tax Treatment:
- Most discharge types are tax-free through December 31, 2025 under the American Rescue Plan Act
- After 2025, discharged amounts may be taxable (except PSLF)
- Consult a tax professional for your specific situation

State Tax Treatment:
- Varies by state
- Some states conform to federal treatment; others do not
- Check with your state tax authority

APPEAL PROCESS

If your discharge application is denied, you may have the right to request reconsideration:

1. Review the denial letter carefully to understand the reason
2. Gather additional documentation that addresses the denial reason
3. Submit a written request for reconsideration within the timeframe specified
4. Include new evidence or clarify any misunderstandings
5. Consider consulting with an attorney if the denial seems improper

RESOURCES

• StudentAid.gov - Federal Student Aid information
• CFPB.gov - Consumer Financial Protection Bureau
• StudentLoanBorrowerAssistance.org - National Consumer Law Center
• NASFAA.org - National Association of Student Financial Aid Administrators
• Your State Attorney General - Consumer protection assistance

This template was last updated on 2026-01-25. Regulations and requirements may change. For the most current information, visit StudentAid.gov or consult with a qualified attorney or student loan counselor.