Apply for Federal Student Loan Debt Relief

OMB No. 1845-0167, Exp. Date 4/30/2023

Eligibility for Debt Relief

What Is Federal Student Loan Debt Relief?
It’s a program that provides eligible borrowers with full or partial discharge of loans up to $20,000 to Federal Pell Grant recipients and up to $10,000 to non-Pell Grant recipients.

Who Qualifies?

Individuals who made less than $125,000 in 2021 or 2020
Families that made less than $250,000 in 2021 or 2020

If you filed federal taxes, your income requirements are based on your adjusted gross income (AGI), which tends to be lower than your total income. Your AGI can be found on line 11 of the IRS Form 1040.

How It Works
Apply today (but no later than Dec. 31, 2023). We’ll determine your eligibility and will contact you if we need more information. Your loan servicer will notify you when your relief has been processed.

Learn More About Student Loan Debt Relief

Borrower Information

First Name

Middle Initial– optional

Last Name

Former Last Name– optional

Enter any other last name you may have provided to the U.S. Department of Education.

Social Security Number (SSN)

Confirm Social Security Number (SSN)

Date of Birth

Month

Day

Year

Phone Number

Confirm Email

Review and Submit the Agreement

By signing this form, you agree with the following statements:

I request federal student loan debt relief of up to $20,000. If requested, I will provide proof of income to the U.S. Department of Education. I understand that if I fail to do so by March 31, 2024 or if my income does not qualify for federal student loan debt relief, the relief will not be processed.
I verify that I am the individual named above.
I affirm that ONE of the following is true for 2020 (Jan. 1–Dec. 31, 2020) or 2021 (Jan. 1–Dec. 31, 2021):
- I made less than the required income to file federal taxes.
- I filed as a single tax-filer AND made less than $125,000.
- I was married, filed my taxes separately, AND made less than $125,000.
- I was married, filed my taxes jointly, AND made less than $250,000.
- I filed as a head of household AND made less than $250,000.
- I filed as a qualifying widow(er) AND made less than $250,000.
If you filed federal taxes, your income requirements are based on your adjusted gross income (AGI), which tends to be lower than your total income. Your AGI can be found on line 11 of the IRS Form 1040.

First Name

Middle Initial– optional

Last Name

I certify under penalty of perjury under the laws of the United States of America that all of the information provided on this form is true and correct. I understand that any falsification or misrepresentation on this form, or on any accompanying document, is subject to penalties that may include fines, imprisonment, or both, under the U.S. Criminal Code, including, but not limited to, under 18 U.S.C. § 1001, 18 U.S.C. § 1621, and 20 U.S.C. § 1097.