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Name: Street Name: City: Zip Code: SS #: Date Student Left the Institution: This is to Certify that I am (Check Only One) Recently Employed Working in South Carolina and wish to defer my loan for a period of one year to cancellation Date of employ : Serving an internship/residency. Type of Program: Institution name: Requesting cancellation of up to $5,000 of my loan for each year of employ within the State of South Carolina. |
State: Date of Birth: Lending Institution: |
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Additional Comments!! :
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