NASA logo NASA Headquarters' Directives
HQPR 3000.1
Effective Date: May 24, 2016
Expiration Date: May 24, 2021
Responsible Office: LM4
Student Loan Repayment Program Plan
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Table of Contents | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | Chapter6 | Chapter7 | Chapter8 | Chapter9 | AppendixA | AppendixB | AppendixC | AppendixD

APPENDIX C

STUDENT LOAN REPAYMENT PROGRAM

OUTSTANDING LOAN INFORMATION

EMPLOYEE NAME:

SSN:

The following information is required for each lender of loan(s) being considered under the Student Loan Repayment Program.

1. Loan Information*:

a. Name of the Federally funded loan received, e.g., Federal Stafford Loan, Federal Plus Loan, Federally Insured Student Loan, etc:

b. Date loan was obtained:

c. Remaining balance of loan:

d. Loan Number:

• Attach an official document/letter by the loan institution providing the above loan information.

2. Name, address, and telephone number of the lending institution holding the loan, e.g. bank, educational institution.

3. Name, address, and telephone number of servicing agent of the loan to whom payments are sent (if different from #2).

4. Name, title, and telephone number of authorized official for the lending institution.

5. Federal Tax Identification Number or EIN (required for sending payments):

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