UNITED
STATES DEPARTMENT OF EDUCATION
ATTESTATION FOR CERTAIN HEALD COLLEGE STUDENTS
APPLICATION FOR BORROWER DEFENSE TO REPAYMENT LOAN DISCHARGE
FORM APPROVED OMB NO: 1845-0132 Exp. 11/30/2018
The Department of Education has found that at various times between 2010 and
2014, Heald College published misleading job placement rates for many of its
programs of study.
This form is designed to expedite the process of obtaining loan forgiveness
based on borrower defense to repayment for loans taken out by Heald College
students to enroll in these programs. This form covers federal Direct Loans
received on or after July 1, 2010. A list of covered programs and dates of
enrollment is available at https://studentaid.ed.gov/sa/sites/default/files/heald-findings.pdf.
Please fill out this attestation ONLY IF your program and dates of enrollment
are included on this list.
Heald College students who did not attend programs where the Department of
Education found misleading job placement rates, or whose decision to enroll was
not influenced by those job placement rates, may still be eligible for loan
forgiveness based on borrower defense to repayment. Additional instructions to
file a claim for loan forgiveness can be found at
studentaid.gov/borrower-defense.
Instructions: Please complete this form. To sign the form, insert a digital
image of your signature in the appropriate field below or print a hard copy of
the form and sign. Submit your form and all supplementary documents referenced
in question #4 via email to BorrowerDefense@ed.gov
or mail to U.S. Department of Education - Borrower Defense to Repayment, PO Box
1854, Monticello, KY 42633.
First
Name ______________________________
Middle Name ______________________________
Last Name ______________________________
Date of Birth ______________________________
Social Security Number (XXX-XX-XXXX) ______________________________
Telephone Number ______________________________
Email Address ______________________________
Home Address ______________________________
City ______________________________
State ______________________________
Zipcode ______________________________
I,__________________ , attest to the following:
I am submitting this attestation and additional materials in support of my
application for a borrower defense to repayment discharge of my Direct Loans
under 34 C.F.R. § 685.206 (c).
If you enrolled in more than one covered Heald program, you
will need to complete the following for each covered program you attended. For
example, if you were a criminal justice student in 2011 and returned in 2012
for an accounting program, you should complete the first Campus Program section
based on your enrollment in criminal justice and the second Campus Program
section based on your enrollment in accounting.
If you have more than one program, click the Add Campus Program button that
appears at the bottom of the Campus Program section.
Note: This form applies to students who enrolled in a program after misleading
placement rates were published for the program. A list of covered programs and
dates of enrollment is available at https://studentaid.ed.gov/sa/sites/default/files/heald-findings.pdf.
The earliest enrollment date covered is July 1, 2010.
CAMPUS PROGRAM
Campus ______________________________
Enrollment Start Date* (MM/YYYY) ______________________________
Enrollment End Date* (MM/YYYY) ______________________________
Program Name ______________________________
Credential______________________________
1. Prior to my enrollment in this Heald College program, I received
information about job placement rates related to my program of study through
one or more of the following ways (check each that applies)
__Brochures advertising Heald College's academic programs or other printed
materials, including those provided by Heald College representatives or
recruiters;
__Emails, online materials, or online disclosures from or by Heald College.
2. I believed that the job placement rates related to my program of study
indicated the level of quality a Heald education offered to students. I chose
to enroll at Heald based, in substantial part, on the information I received
about job placement rates related to my program of study and the quality of
education I believed those placement rates represented.
3. I applied for and received a federal Direct Loan to cover the cost of
attendance of the Heald program in which I enrolled.
4. As an attachment to this attestation, I have included documents(s) with
additional information to confirm that I was enrolled in the program of study
at Heald College that I identified above, and was enrolled for the dates I
provided above. (Suggested documents include transcripts and registration
documents indicating your specific program of study at Heald College and dates
of enrollment.) The document(s) I have attached are:
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__ *Select the check box if you had multiple periods of enrollment in a
program, that is, if you enrolled in a program but subsequently discontinued
enrollment, and then reenrolled in the same program at a later date, please
provide all start and end dates applicable to this program. (Selecting the box
provides user ability to add multiple periods of enrollment. Deselect the check
box to remove any enrollment dates added in error.)
ADD CAMPUS PROGRAM BUTTON [Allows to add an additional campus program by
repeating questions 1-4 above]
REMOVE CAMPUS PROGRAM BUTTON [Removes additional campus program section
previously added by clicking the ADD CAMPUS BUTTON]
Please
provide or attach any other information about your experience at Heald College
that you believe is relevant: (2,000 characters max)
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
By
completing this form, you are eligible to have all of your federal loans placed
into forbearance and for collections on any federal loans in default to stop while
your claim is reviewed by the Department of Education. Please read the
following information carefully before making your selection below.
During any period that your loans are in forbearance, you do not have to make
payments on those loans, and the loans will not go into default. If your loans
are already in default, collections will stop. This will continue until the
loan discharge review process is completed. Your servicer will notify you when
your loan has been placed into forbearance or stopped collections. Until you
receive that notice, you should continue to make payments.
The forbearance or stopped collections will affect all of a borrower's federal
loans, including loans that are not eligible for discharge through this form,
such as Federal Family Education Loans (FFEL), loans taken out to attend a
Heald College program not on the enclosed list of covered programs, or loans
taken out to attend another institution.
Note that interest will continue to accrue on all of these federal loans,
including subsidized loans, during the forbearance or stopped collections
period.
If you want the forbearance or stopped collections to apply only to those loans
that may be eligible for a discharge using this form (federal Direct Loans
received on or after July 1, 2010 to attend Heald College programs covered by
the enclosed list), you must notify your loan servicer. At any time during the
forbearance or stopped collections period, you may voluntarily make payments on
your loans, including payments for accrued interest, or end the forbearance or
stopped collections by contacting your servicer.
If your claim made using this form is successful, your federal Direct Loans
borrowed to attend a covered Heald College program will be discharged. Also at
that time, the forbearance or stopped collections period for your other federal
loans will end. You will be responsible for repaying these other remaining
loans, including interest that accrued during the forbearance or stopped
collections period, under the terms of your promissory note.
If your claim is denied, you will not receive a discharge of any of your loans
and the forbearance or stopped collections period will end for all of your
loans. You will be responsible for repaying these loans, including interest
that accrued during the forbearance or stopped collections period, under the
terms of your promissory note.
__ Yes, I want my federal loans to be placed in forbearance and for collections
to stop on any loans in default while my loan discharge claim is reviewed.
__ No, I do not want my federal loans to be placed in forbearance and for
collections to stop on any loans in default while my loan discharge claim is
reviewed.
By
signing this attestation I certify that:
I agree to provide, upon request, testimony, a sworn statement, or other
documentation reasonably available to me that demonstrates to the satisfaction
of the Department of Education or its designee that I meet the qualifications
for borrower defense to repayment loan discharge.
All of the information I provided is true and complete to the best of my
knowledge and I agree, if asked, to provide information reasonably available to
me to the Department of Education that will verify the accuracy of my completed
attestation.
I understand that the Department of Education has the authority to verify
information reported on this application with other federal or state agencies
or other entities. I authorize the Department of Education, along with its
agents and contractors, to contact me regarding this request at the phone
number above using automated dialing equipment or artificial or prerecorded
voice or text messages.
I understand that if I purposely provided false or misleading information on
this application, I may be subject to the penalties specified in 18 U.S. Code §
1001.
Signature______________________________
Date______________________________
According
to the Paperwork Reduction Act of 1995,
no persons are required to respond to a collection of information unless such
collection displays a valid OMB control number. The valid OMB control number
for this information collection is 1845-0132. Public reporting burden for this
collection of information is estimated to average 1 hour per response,
including time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the
collection of information. The obligation to respond to this collection is
required to obtain or retain a benefit (20 U.S.C. 1087e(h)). If you have
comments or concerns regarding the status of your individual submission of this
application, please contact BorrowerDefense@ed.gov.