Loan Adjustment Request Form

Please complete and submit this form if you would like to cancel or reduce your loan(s).

Student Name Student Name * First Last
Student ID Number *
Must be 7 digits. Currently Entered: 0 digits.
Email *
Student Type: *

Student Type: Undergraduate Graduate
Loan Type: *

Loan Type: Direct Stafford (Subsidized or Unsubsidized) Parent PLUS Graduate PLUS Private
Lender/Bank Name *
I would like to: *

I would like to: Cancel my loan Reduce my loan
Which loan(s): *

Which loan(s): Direct Subsidized Loan Direct Unsubsidized

Select all that apply.
I would like to cancel my loan for the *

I would like to cancel my loan for the Year (2019-2020) Year (2020-2021) Term
I would like to cancel my loan for the following term: *

Ex: Fall 2019 or Winter 2020
I would like to reduce my loan for the *

I would like to reduce my loan for the Year (2019-2020) Year (2020-2021) Term
I would like to reduce my loan for the following term: *

Ex: Fall 2019 or Winter 2020
This year (2019-2020) I will enroll in the following semesters and specified number of credits (not classes).

Fall '19 - # credits
Spring '20 - # credits
Summer '20 - # credits
Please reduce my loan *

Please reduce my loan To cover my balance only To give me a refund of: To leave a balance of:
$ Dollars . Cents
Student Name Student Name * First Last
Today's Date Today's Date * / MM / DD YYYY
Draw your signature into the box below. *

Clear
Parent's Name Parent's Name * First Last
Today Date Today Date * / MM / DD YYYY
Draw your signature into the box below. *

Clear
Type the letters you see in the image below.