Educational Loan Default Statement

Public Act 85-827 requires that any application forms used by state agencies shall include a statement to be signed by the applicant concerning whether the applicant is in default on a student loan. Each applicant must complete this form by checking one of the following two boxes, signing and dating the form, and submitting it along with other employment application forms:

  • [ ] I am not in default for a period of six months or more and in the amount of $600 or more on the repayment of any educational loan guaranteed by the State Scholarship Commission or made by an Illinois institution of higher education or any other loan made form public funds for the purpose of financing higher education.
  • [ ] I am currently in default on a student loan as described in the preceding paragraph. (Note: A state agency is required to terminate employment of any employee who had not made a satisfactory repayment arrangement with the maker or guarantor of the loan prior to completion of the sixth month of employment).

Applicant’s signature

Applicant’s name — please print


Social Security Number