Loan Adjustment Form 2023-2024

Please note, if your loan has already disbursed, we can no longer reduce it, and you must contact your loan servicer to reduce the loan.

Simmons Email
**If you would like to request an adjustment to a loan for fall 2024 or later, please use our 2024-2025 Loan Adjustment Form**
Student Name Student Name First Last
Student Type

Student Type Undergraduate Graduate
Student ID Number
Must be 7 characters. Currently Entered: 0 characters.
Which program do you attend:

Which program do you attend: On-Campus Undergraduate or Graduate Program Online Undergraduate-Complete Degree Program Online Graduate-Library Science or Nutrition Online Graduate-Social Work, Nursing, or Behavior Analysis Online Graduate-Public Health
I plan to waive or have waived the university health insurance:

I plan to waive or have waived the university health insurance: Yes No

Checking this box does not mean the health insurance has been waived. You can complete the waiver at universityhealthplans.com
Loan Type
Lender/Bank Name
I would like to:
Please cancel my loan for the:

Please cancel my loan for the: Year (Fall 2023 - Summer 2024) Term/Semester
Which loan(s):

Which loan(s): Subsidized Unsubsidized
Please adjust my loan for the:

Please adjust my loan for the: Year (Fall 2023 - Summer 2024) Term/Semester
I would like to cancel my loan for the following semester
I would like to adjust my loan for the following semester
Please adjust my loan to:

Please adjust my loan to: Cover my balance only Give me a refund of Leave a balance due (that I will pay out of pocket) of
Desired Dollar Amount Per Semester:

Please specify your requested refund or balance due per semester.

For example:
Fall 2022: $1,000
Spring 2023: $500
Summer 2023: $500
Enrollment Plans

Please enter the number of credits for which you will enroll at Simmons during each semester. Enter 0 if you will not/did not enroll for a given semester.

Please note, you must enroll in 5+ credits as a graduate student, and 6+ credits as an undergraduate student per semester, to be eligible for federal student loans in a given semester.
Fall 2023 - Number of Credits
Spring 2024 - Number of Credits
Summer 2024 - Number of Credits
Loan Borrower Name Loan Borrower Name First Last
Today's Date Today's Date / MM / DD YYYY
Loan Borrower Signature:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Agreements
I acknowledge that by signing this form I understand and agree to the following statements

I acknowledge that by signing this form I understand and agree to the following statements All information provided is complete and accurate to the best of my knowledge. I will promptly submit any additional documentation requested by Student Financial Services. Omitting or misreporting information on this form may result in a change or delay to my financial aid. I will immediately notify SFS in writing if any information on this form changes and understand the change may impact my eligibility for aid. In the event that I do not notify SFS of a change in my enrollment plans, my actual enrollment will be reviewed at the beginning of the term and my financial aid will be adjusted at that time, if necessary. I understand that if my loan has already disbursed, SFS may not be able to adjust/cancel my loan and I would instead need to contact my loan lender.

Loan Adjustment Form 2023-2024

Loan Adjustment Form 2023-2024

Enrollment Plans

Agreements