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Loan Discharge Application: False Certification ...

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LOAN Discharge APPLICATION: False Certification ( unauthorized signature /PAYMENT) William D. Ford Federal Direct Loan (Direct Loan) Program Federal Family Education Loan (FFEL) ProgramOMB No. 1845-0058 Form Approved Exp. Date 9/30/2020WARNING: Any person who knowingly makes a False statement or misrepresentation on this form or on any accompanying document is subject to penalties that may include fines, imprisonment, or both, under the Criminal Code and 20 1: BORROWER IDENTIFICATIONPlease enter or correct the following this box if any of your information has CodeTelephone - PrimaryTelephone - AlternateEmail (Optional)SECTION 2: unauthorized signature /PAYMENT INFORMATIONDo not use this application for allegations of identity theft. If you believe that your identity has been stolen, contact your loan holder.

LOAN DISCHARGE APPLICATION: FALSE CERTIFICATION (UNAUTHORIZED SIGNATURE/PAYMENT) William D. Ford Federal Direct Loan (Direct Loan) Program ... I assign and transfer to the U.S. Department of Education (the Department) any right I have to a refund on the amount discharged from the school and/or from any owners, affiliates, or assignees of the ...

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