The name and address of the person or organization to whom this LOAN was
offered or transferred and the date and purpose of such offer or transfer.
SECTION 2: LOANER. The LOANER'S: Name, address and/or telephone number if known
and information regarding any prior borrowers or co-borrowers.
SECTION 3: OFFER OR. The LOANY-PROOF OFFER OR'S: Name, address and/or telephone number if known
and information regarding any prior borrowers or co-borrowers. (SALES TAX STATEMENT REQUIRED.)
SECTION 4: DESCRIPTION OF LOAN. The LOAN TERM for this LOAN, if known. (STILL BORROWING AND OTHER STOCK INCOMES ARE NOT DEEMED LOAN. NOT ALL STUDENTS AND GRADES ARE ELIGIBLE)
SECTION 5: INVESTMENT. The name, address, and telephone number where funds from this LOAN have been invested. The
LOAN is paid in full at the time it is deposited with the school, institution and/or other person in question.
SECTION 6: PAYMENT METHOD. The method of payment (sender's name, date and amount of payment)
SECTION 7: MATERIAL SUBMITTED BY THE LOANER. (Required)
SECTION 8: LENDERS. The name and address of the credit organization, whether individual or entity where funds are
used for the PURPOSE of acquiring property.
SECTION 9: APPLICATION FOR LOAN. If the LOAN is secured by a LENDER, include full lender-liability
SECTION 11: AMOUNT OF LOAN. The total amount of the LOAN.
SECTION 12: PURPOSE OF LOAN. The LOANER'S: Purpose for which this LOAN was given or
SECTION 13: PERIOD COVERED. The LOANER'S CURRENT AGE or AGE THE LOAN IS OFFERING (NOT A BEGINNING OR ENDING AGE)
SECTION 14: PURPOSE FOR which the RECEIPT OF THE LOAN WILL CONTINUE.
SECTION 15: AFFIRMATION OF Loaned.
SECTION 17: FEDERAL TAXATION REQUIREMENTS. All federal tax laws apply to this LOAN.
Navient Form 1845-0058 free printable template
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LOAN DISCHARGE APPLICATION: SCHOOL CLOSUREOMB No. 18450058
Form Approved
Exp. Date 08/31/2017William D. Ford Federal Direct Loan (Direct Loan) Program, Federal Family
Education Loan (FFEL) Program,
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