Automatic Debit Authorization Form Downloaded from SallieMae.com Page 1 of 9. Here s what you need to know: How to Enroll in Automatic Debit:
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1 Downloaded from SallieMae.com Page 1 of 9 Enrolling in auto debit is a convenient way to make payments. You could also receive a 0.25 percentage point interest rate reduction on your eligible loan(s).* Here s what you need to know: By enrolling in auto debit, you can help ensure that your payments will be made on time. Each month we ll automatically deduct the Current Amount Due from the designated bank account on the Current Amount Due Date. The Current Amount Due will be withdrawn from the designated bank account every month, even if other payments have been made toward the loan(s) and/or the Current Amount Due has been satisfied in full. o During the first billing period you re enrolled in auto debit, any additional payment(s) made prior to the first automatic debit payment date will reduce the amount deducted from the automatic debit payment amount. If the additional payment is enough to satisfy the Current Amount Due, the first automatic debit payment will be skipped. For example, if the Current Amount Due is $100 during the billing period you enroll, and you make a payment of $25 before the scheduled withdrawal date, your first auto debit withdrawal will be $75. If you make a payment of $100 before the scheduled withdrawal date, there will not be an auto debit withdrawal. All future withdrawals will be for the Current Amount Due as reflected on your billing statements. The loan(s) must be current to enroll in auto debit. If the loan(s) is past due, either make a payment to bring the loan current or complete Section III on the form to authorize us to cover the Past Due Amount with available forbearance time. Written requests may take up to 2 full billing periods for enrollment to be effective. Online requests may take up to 1 full billing period to be effective, and your scheduled automatic payment date will be disclosed. Please continue to make payments until your billing statement reflects your enrollment. If you are the borrower and your loan(s) is current, you may be able to enroll online. If you are the cosigner for all of the loans within the borrower s billing group and all of the loans are current, you may also be able to enroll online. If you did not cosign all of the loans in the borrower s billing group, you will need to submit this form. How to Enroll in Automatic Debit: 1. Keep a copy for your records. 2. Return the completed form to us using one of the following options: o Online: Log in to your account at SallieMae.com, and select the Secure Document Upload link located on the Forms page. o Mail: Sallie Mae, P.O. Box 3319, o Fax: Questions? Visit us online at SallieMae.com, or call us at SALLIE ( ). We re here to help you Monday Thursday 8 a.m. to 9 p.m., Friday 8 a.m. to 8 p.m., and Saturday 9 a.m. to 6 p.m. ET. * Borrower or cosigner (not both) must enroll in auto debit through Sallie Mae. The rate reduction benefit applies only during active repayment for as long as the Current Amount Due is successfully deducted from the designated bank account each month, and is suspended during forbearances and certain deferments.
2 Downloaded from SallieMae.com Page 2 of 9 Please complete the following information, and return all documentation to us via fax: , mail: Sallie Mae, P.O. Box 3319,, or online: log in to your account at SallieMae.com and select the Secure Document upload link located on the Forms page. Agreement: I, the bank account holder, authorize Sallie Mae and its successors and assigns (collectively Sallie Mae ) to debit (from the bank account listed below) the Current Amount Due (the amount you are required to pay each month until the loan is paid in full) for the borrower s loans associated with the 10-digit account number listed above. However, I understand that this authorization will not cover any future loans. Note: If I am the cosigner and bank account holder, I will only be enrolled in auto debit for the loan(s) that I cosigned that is included in the borrower s account number I reference above. If the borrower has additional loans with Sallie Mae that I have not cosigned, Sallie Mae may place the other loans in a different loan group if required. To obtain the borrower s account number, ask the borrower for the information. If I want the electronic withdrawals from my bank account to cover only specific loans, other than those referenced in the first bullet above, I will provide Sallie Mae with separate written instructions that clearly specify the loan(s) that I want to be included/excluded from my authorization to the address listed above. I understand that if I have scheduled a payment to be allocated among loans in different loan groups, or multiple loan types within the same loan group, the portion of the payment allocated to each loan will be debited from the designated bank account in separate transactions. I authorize Sallie Mae to debit my bank account on or after the Current Amount Due Date (or next business day in the event of a weekend or holiday), or in accordance with any future instructions that I provide, including verbal or electronic instructions. I understand that if a payment is returned, there may be a fee charged for the returned payment in addition to any fee I may be charged by my bank. I authorize Sallie Mae to make a one-time electronic fund transfer from my bank account to collect the fee. I acknowledge and agree that I m responsible for overdraft, insufficient funds, and other service charges that my bank may impose in connection with the bank account listed below. I understand that any changes to the Current Amount Due deducted from my bank account via automatic debit will not be implemented until after Sallie Mae has sent me at least 10-days advance notice. I understand that the Current Amount Due will be withdrawn from my bank account every month, even if other payments toward the loan(s) have been made and/or the Current Amount Due has been otherwise satisfied in full. o Note: During the first billing period I am enrolled in automatic debit, any additional payment(s) made prior to the first automatic debit payment date will reduce the automatic debit payment amount. If the additional payment is enough to satisfy the Current Amount Due, the first automatic debit payment will be skipped. I understand that by enrolling in automatic debit, the pay in advance feature of my loan(s) will be suspended, and any amount that I have paid ahead will remain applied to the Current Balance, but will no longer reduce the amount of future payments. I understand that during authorized periods of deferment and forbearance, if no Current Amount Due is required, Sallie Mae will not deduct a payment. However, as soon as the deferment or forbearance ends, Sallie Mae will resume automatic payments. I authorize Sallie Mae to debit or credit my bank account to correct any error Sallie Mae makes in processing a payment.
3 Downloaded from SallieMae.com Page 3 of 9 Agreement (continued): This authority shall remain in effect until Sallie Mae receives notification from me (the bank account holder) of its termination or until the loan(s) is paid in full. o I may terminate this authorization: Online: Log in to my account at SallieMae.com. Phone: Call Sallie Mae at SALLIE ( ). Mail: Write Sallie Mae at the address listed above. Sallie Mae will cancel an automatic withdrawal if they receive my online or telephone request to do so at least three business days before the date of the next debit of the Current Amount Due. I may also mail a written request to the address listed above, allowing enough time so that it is received by Sallie Mae at least three business days before the date of the next debit of the Current Amount Due. If my request to terminate is not received in time to cancel the next debit of the Current Amount Due, Sallie Mae will terminate automatic debits immediately following withdrawal. Sallie Mae reserves the right to terminate automatic debit without warning for any reason, including but not limited to, if payments are unauthorized or returned unpaid, and I will be notified if that occurs. Any termination of this authorization will not relieve the borrower or any cosigner of his or her obligation to pay the Current Amount Due each month. If my loan(s) qualifies for an interest rate reduction when enrolled in automatic debit, it may take up to two billing periods for the interest rate reduction to take effect. If I am enrolling any loan(s) that was previously disqualified from automatic debit due to returned payments, the loan(s) will not be eligible for an interest rate reduction upon re-enrollment.
4 Downloaded from SallieMae.com Page 4 of 9 Section I: Bank Account Holder Information: Please check the appropriate option: I am the borrower for the loan(s) being paid. I am the cosigner for the loan(s) being paid. Name (as it appears on the bank account) Street Address City State Zip Phone Number By providing my telephone number, I authorize Sallie Mae Bank, and its subsidiaries, affiliates, and agents, to contact me at such number using any means of communication, including, but not limited to, calls placed to my cellular phone using an automated dialing service, calls using pre-recorded messages and/or SMS text messages, regarding this Automatic Debit Authorization Form or any current or future loans owned or serviced by Sallie Mae Bank or its subsidiaries, affiliates, and agents, even if I will be charged by my service provider(s) for receiving such communications. Section II: Bank Account Information and Authorization: Type of Bank Account (check one): Checking Savings Bank Account Number: ABA Bank Routing Number*: *Nine-digit number usually preceding bank account number Bank Account Holder Signature Date
5 Downloaded from SallieMae.com Page 5 of 9 Section III*: Authorization for Forbearance (Borrower and/or Cosigner): *If the loan(s) is current, you do not need to complete this section. *If the loan(s) is past due, you can bring the loan(s) current by paying the Past Due Amount or by signing this forbearance authorization section. Note: If the loan(s) is more than two billing periods past due, you should not fill out this section. Instead, call us at SALLIE ( ). Important Information When Considering Using Forbearance: You re responsible for the interest that accrues during the forbearance period. If you choose not to pay the interest during this time, the Unpaid Interest will be capitalized (added to the Current Principal) as frequently as quarterly and at the end of this period. As a result, more interest may accrue over the life of the loan, the Current Amount Due may be higher, and more payments may be required. We encourage you to consider paying at least the interest as it accrues, which will save you money over the life of the loan. If your loan(s) was past due and your delinquency has been reported to the consumer reporting agencies, information that was reported and any late fees charged before the forbearance is processed will not be removed. Forbearance may affect any borrower benefit or repayment incentives applicable to your loan(s) as described below: The automatic debit rate reduction benefit applies only during active repayment for as long as the Current Amount Due is successfully deducted from the designated bank account each month, and is suspended during forbearance. Forbearance may affect your eligibility for, or cause you to lose, borrower benefits or repayment incentives, such as cosigner release, that require on-time payments to obtain the benefit or retain it after qualifying. Please call us at SALLIE ( ) to find out the impact forbearance will have on your borrower benefit or repayment incentive. Any scheduled loan disbursements during this forbearance period will be canceled. Additionally, the use of forbearance may also impact your ability to get Sallie Mae loans in the future. By signing below, I agree to the terms above, and certify that I have a Past Due Amount on my loan(s) due to hardship and request forbearance to bring my loan(s) current before automatic debit begins. Name Signature Date
6 Downloaded from SallieMae.com Page 6 of 9 Please complete the following information, and retain this copy for your records. Agreement: I, the bank account holder, authorize Sallie Mae and its successors and assigns (collectively Sallie Mae ) to debit (from the bank account listed below) the Current Amount Due (the amount you are required to pay each month until the loan is paid in full) for the borrower s loans associated with the 10-digit account number listed above. However, I understand that this authorization will not cover any future loans. Note: If I am the cosigner and bank account holder, I will only be enrolled in auto debit for the loan(s) that I cosigned that is included in the borrower s account number I reference above. If the borrower has additional loans with Sallie Mae that I have not cosigned, Sallie Mae may place the other loans in a different loan group if required. To obtain the borrower s account number, ask the borrower for the information. If I want the electronic withdrawals from my bank account to cover only specific loans, other than those referenced in the first bullet above, I will provide Sallie Mae with separate written instructions that clearly specify the loan(s) that I want to be included/excluded from my authorization to the address listed above. I understand that if I have scheduled a payment to be allocated among loans in different loan groups, or multiple loan types within the same loan group, the portion of the payment allocated to each loan will be debited from the designated bank account in separate transactions. I authorize Sallie Mae to debit my bank account on or after the Current Amount Due Date (or next business day in the event of a weekend or holiday), or in accordance with any future instructions that I provide, including verbal or electronic instructions. I understand that if a payment is returned, there may be a fee charged for the returned payment in addition to any fee I may be charged by my bank. I authorize Sallie Mae to make a one-time electronic fund transfer from my bank account to collect the fee. I acknowledge and agree that I m responsible for overdraft, insufficient funds, and other service charges that my bank may impose in connection with the bank account listed below. I understand that any changes to the Current Amount Due deducted from my bank account via automatic debit will not be implemented until after Sallie Mae has sent me at least 10-days advance notice. I understand that the Current Amount Due will be withdrawn from my bank account every month, even if other payments toward the loan(s) have been made and/or the Current Amount Due has been otherwise satisfied in full. o Note: During the first billing period I am enrolled in automatic debit, any additional payment(s) made prior to the first automatic debit payment date will reduce the automatic debit payment amount. If the additional payment is enough to satisfy the Current Amount Due, the first automatic debit payment will be skipped. I understand that by enrolling in automatic debit, the pay in advance feature of my loan(s) will be suspended, and any amount that I have paid ahead will remain applied to the Current Balance, but will no longer reduce the amount of future payments. I understand that during authorized periods of deferment and forbearance, if no Current Amount Due is required, Sallie Mae will not deduct a payment. However, as soon as the deferment or forbearance ends, Sallie Mae will resume automatic payments. I authorize Sallie Mae to debit or credit my bank account to correct any error Sallie Mae makes in processing a payment.
7 Downloaded from SallieMae.com Page 7 of 9 Agreement (continued): This authority shall remain in effect until Sallie Mae receives notification from me (the bank account holder) of its termination or until the loan(s) is paid in full. o I may terminate this authorization: Online: Log in to my account at SallieMae.com. Phone: Call Sallie Mae at SALLIE ( ). Mail: Write Sallie Mae at the address listed above. Sallie Mae will cancel an automatic withdrawal if they receive my online or telephone request to do so at least three business days before the date of the next debit of the Current Amount Due. I may also mail a written request to the address listed above, allowing enough time so that it is received by Sallie Mae at least three business days before the date of the next debit of the Current Amount Due. If my request to terminate is not received in time to cancel the next debit of the Current Amount Due, Sallie Mae will terminate automatic debits immediately following withdrawal. Sallie Mae reserves the right to terminate automatic debit without warning for any reason, including but not limited to, if payments are unauthorized or returned unpaid, and I will be notified if that occurs. Any termination of this authorization will not relieve the borrower or any cosigner of his or her obligation to pay the Current Amount Due each month. If my loan(s) qualifies for an interest rate reduction when enrolled in automatic debit, it may take up to two billing periods for the interest rate reduction to take effect. If I am enrolling any loan(s) that was previously disqualified from automatic debit due to returned payments, the loan(s) will not be eligible for an interest rate reduction upon re-enrollment.
8 Downloaded from SallieMae.com Page 8 of 9 Section I: Bank Account Holder Information: Please check the appropriate option: I am the borrower for the loan(s) being paid. I am the cosigner for the loan(s) being paid. Name (as it appears on the bank account) Street Address City State Zip Phone Number By providing my telephone number, I authorize Sallie Mae Bank, and its subsidiaries, affiliates, and agents, to contact me at such number using any means of communication, including, but not limited to, calls placed to my cellular phone using an automated dialing service, calls using pre-recorded messages and/or SMS text messages, regarding this Automatic Debit Authorization Form or any current or future loans owned or serviced by Sallie Mae Bank or its subsidiaries, affiliates, and agents, even if I will be charged by my service provider(s) for receiving such communications. Section II: Bank Account Information and Authorization: Type of Bank Account (check one): Checking Savings Bank Account Number: ABA Bank Routing Number*: *Nine-digit number usually preceding bank account number Bank Account Holder Signature Date
9 Downloaded from SallieMae.com Page 9 of 9 Section III*: Authorization for Forbearance (Borrower and/or Cosigner): *If the loan(s) is current, you do not need to complete this section. *If the loan(s) is past due, you can bring the loan(s) current by paying the Past Due Amount or by signing this forbearance authorization section. Note: If the loan(s) is more than two billing periods past due, you should not fill out this section. Instead, call us at SALLIE ( ). Important Information When Considering Using Forbearance: You re responsible for the interest that accrues during the forbearance period. If you choose not to pay the interest during this time, the Unpaid Interest will be capitalized (added to the Current Principal) as frequently as quarterly and at the end of this period. As a result, more interest may accrue over the life of the loan, the Current Amount Due may be higher, and more payments may be required. We encourage you to consider paying at least the interest as it accrues, which will save you money over the life of the loan. If your loan(s) was past due and your delinquency has been reported to the consumer reporting agencies, information that was reported and any late fees charged before the forbearance is processed will not be removed. Forbearance may affect any borrower benefit or repayment incentives applicable to your loan(s) as described below: The automatic debit rate reduction benefit applies only during active repayment for as long as the Current Amount Due is successfully deducted from the designated bank account each month, and is suspended during forbearance. Forbearance may affect your eligibility for, or cause you to lose, borrower benefits or repayment incentives, such as cosigner release, that require on-time payments to obtain the benefit or retain it after qualifying. Please call us at SALLIE ( ) to find out the impact forbearance will have on your borrower benefit or repayment incentive. Any scheduled loan disbursements during this forbearance period will be canceled. Additionally, the use of forbearance may also impact your ability to get Sallie Mae loans in the future. By signing below, I agree to the terms above, and certify that I have a Past Due Amount on my loan(s) due to hardship and request forbearance to bring my loan(s) current before automatic debit begins. Name Signature Date
Automatic Debit Authorization Application Downloaded from SallieMae.com Page 1 of 9. Here s what you need to know: How to Enroll in Automatic Debit:
Downloaded from SallieMae.com Page 1 of 9 Enrolling in auto debit is a convenient way to make payments. You could also receive a 0.25 percentage point interest rate reduction on your eligible loan(s).*
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