12
5 Thomas Boyd Hall
• Baton Rouge, LA 70803 • P 225-578-3092 • F 225-578-3969 • perkinsloan@lsu.edu
Louisiana State University
Office of Accounting Services
Bursar Operations – Perkins Loan
125 Thomas Boyd Hall
FEDERAL PERKINS LOAN PROGRAM - APPLICATION FOR SPECIAL PAYMENT ARRANGEMENT
An institution may permit a borrower to make reduced monthly payments on his/her Federal Perkins Loan for a limited
time if the school determines this is warranted. The normal length of such an arrangement is six (6) months.
Note: Principal and Interest continue to accrue at the rate of the regular monthly payment. Any amounts not paid
during the arrangement will be due with the first payment following the end of the arrangement.
__________________________________________________________________________________________________
Name: __________________________________ LSUID: __________________________________________
Mailing Address: _____________________________________________________________________________
City:
____________________________________ State: ________ Zip Code: __________________________
E-mail:
__________________________________ Phone Number: ___________________________________
The following questions must be answered and/or supporting documentation attached for the application for special
payment arrangement to be processed.
• What is the specific dollar amount you are proposing to pay each month? ___________________________
• Provide a breakdown on the monthly income and expenses of your household.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
• Attach documentation of your most recent total monthly gross income (i.e. pay stub).
• Attach documentation of your most recent monthly payments due on your post-secondary educational loans
obtained through a federal education loan program.
• Briefly explain your reasons for requesting a reduced payment. Please include how you anticipate your financ
ial
s
ituation will improve.
___________________________________________________________________________________________
___________________________________________________________________________________________
___________________________________________________________________________________________
I have enclosed a check/money order for the amount of $__________________.
_____________________________________________ ______________________________
Signature of Borrower Date
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FOR ACCOUNTING SERVICES USE ONLY
Approved Disapproved From: (MM/DD/YEAR) _______________To: (MM/DD/YEAR) _________________
Reviewed by ______________________________________________ Date ___________________
