School Enrollment Verification Form - Discover Card

1 Borrower s InformationFirst Name MI Last Name Last 4 of SSN Phone Number --Borrower s Street Address City State Zip Signature Date // MM DD YYYYS chool NameStreet Address School Code City State Zip Phone Number --Signature of Authorized Official Date // MM DD YYYYName/Title of Authorized OfficialMy anticipated graduation date is // MM DD YYYYThe School may attach its own Enrollment certification report listing the required information in lieu of completing this borrower:1.

2 Is/was enrolled at least half-time during the academic period: from // to // MM DD YYYY MM DD YYYY2. Is reasonably expected to complete his/her program requirements on: // MM DD YYYYI am enrolled as a continuous (at least half-time) student at ( School Name)Borrower Instructions: If you wish to defer your payments while you are enrolled in School at least half time, complete Section 1 of this form. Take the form to the School Registrar s office for completion of Section 2. Once the School has completed Section 2, please send the completed form, with your deferment application, using one of the following methods: Mail: Discover Student Loans Customer Service PO Box 30948 Salt Lake City, UT 84130-0948 Secure Document Upload: (login required)Fax: 1-224-813-5210 Section 2.

3 Authorized Official s Certification (Please print or type)I certify, to the best of my knowledge and belief that the borrower named above is/was enrolled as at least a half-time student as indicated in Section 1. To Be Completed By BorrowerPlease read: Please call us at 1-800-STUDENT if your loan application was received before 03/31/2012 and you have CitiAssist Loan(s) that was purchased by Discover , you may qualify for In- School deferment if you are enrolled less than half Enrollment Verification Form