Section 1: Borrower information
Your Social Security number, date of birth, name, address, primary phone number and email.
PSLF
Public Service Loan Forgiveness (PSLF) Application
- Agency
- Federal Student Aid
- Revision
- OMB No. 1845-0110, expires 01/31/2027
- Fillable fields
- 30
- Pages
- 16
- Official source
- Federal Student Aid form page
- Checked
- October 20, 2026
Public Service Loan Forgiveness (PSLF) & TEPSLF Certification & Application
The Public Service Loan Forgiveness (PSLF) & Temporary Expanded PSLF (TEPSLF) Certification & Application is a U.S. Department of Education form, published by Federal Student Aid, for loans under the William D. Ford Federal Direct Loan (Direct Loan) Program. One form does two jobs. It certifies a period of work with one employer, and it asks the Department to decide whether you qualify for PSLF or TEPSLF and to discharge any qualifying loans. If none of your loans qualify yet, the Department counts how many qualifying payments you have made.
The borrower fills out Sections 1 and 2, which the form says must be completed in their entirety, and Section 4 about the employer. An authorized official of the employer signs Section 5A. If the employer has closed or cannot certify, Section 5B allows other documents instead. The form says to complete it annually or any time you change employers or employment status.
The form recommends the online PSLF Help Tool at StudentAid.gov/pslf, which can prefill employer details and send the form to your employer for an electronic signature. You can also fill out the PDF free in your browser on this page and download the result without an account.
What's on the PSLF form
Section 2: Request and certification
Your request to be considered for PSLF or TEPSLF and to have your qualifying payments counted, the optional forbearance box, five statements about how forgiveness works, and your signature and date.
Section 4: Employer information
The employer's FEIN/EIN, name, address and website, the employment begin date and end date or a Still Employed box, full-time or part-time status, and average hours per week rounded up. A box marks an employer that has closed or cannot certify.
Section 5A: Employer certification
The authorized official's name, title, phone, email, signature and date. The form says this section must be completed by the employer.
Section 5B: Alternative documentation
Used only if Section 5A cannot be completed. The form asks for a Form DD-214 or SCRA Status Report for military service, or W-2s for every calendar year or paystubs for every month for other employers.
Sections 6 to 11: Instructions and notices
Line by line instructions, definitions, where to send the form, how to get help, details about PSLF and TEPSLF, and the Privacy Act and Paperwork Reduction notices.
How to fill out the PSLF form
- 1
Fill out Sections 1 and 2
Type or print in dark ink and write dates as mm/dd/yyyy. To correct an answer, the form says to cross it out, write the correct answer and initial the change.
- 2
Find the employer's FEIN/EIN
The form says it is usually in box b of your W-2. If your employer uses a Professional Employer Organization (PEO), or you work under certain contracts, it says to get the qualifying employer's FEIN/EIN directly.
- 3
Enter the period and your hours
Give the begin date and the end date or check Still Employed. The form counts full-time as an average of 30 hours or more per week, including vacation and FMLA leave but not volunteer time.
- 4
Get the employer certification
An authorized official checks Section 4 and signs Section 5A. If the employer has closed or cannot certify, check the box in Section 4 and attach the documents listed in Section 5B.
- 5
Send pages 1 to 4
Mail, fax or upload the form and any documents. The form says to leave out pages 5 to 16 when mailing or faxing.
- 6
Read the determination
The form says that if you are not yet eligible, you will be told the determination, why it was made and how many qualifying payments you have made toward PSLF and TEPSLF.
Why fill Form PSLF on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the Federal Student Aid, not a copy someone retyped
- Works on a phone, tablet or computer
Where to send the PSLF form
U.S. Department of Education, P.O. Box 300010, Greenville, TX 75403.
Fax
540-212-2415.
Upload
Log in to StudentAid.gov and visit My Activity.
Online with the PSLF Help Tool
At StudentAid.gov/pslf, the form says you can search the PSLF Employer Database, sign electronically, and ask your employer to sign electronically, after which the form is submitted to the Department for you.
Help
Section 9 lists 1-888-303-7818 (TTY: dial 711, then the number) and StudentAid.gov. The Paperwork Reduction Notice estimates an average of 30 minutes to complete the form.
Section 8 of the form lists three ways to return it with any documents.
Related forms
IDR Plan Request
Income-Driven Repayment (IDR) Plan Request
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Repayment Plan Request
Repayment Plan Request
19 fields, 7 pages
General Forbearance
General Forbearance Request
24 fields, 8 pages
Joint Consolidation Separation
Joint Consolidation Loan Separation Application and Promissory Note
58 fields, 38 pages
TPD Discharge
Total and Permanent Disability Discharge Application
45 fields, 19 pages
1098-E
Student Loan Interest Statement
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Who uses the PSLF form?
These are the form's own terms for who it applies to. The Department makes the eligibility decision.
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Questions about Form PSLF
Can I type my name as the signature on the PSLF form?
No. The form says typed names, even in a cursive style font, and certificate-based signatures are not acceptable. It accepts a handwritten signature in dark ink, a signature drawn with a mouse or finger on a digital device, or an embedded image of a handwritten signature. The employer's official signs the same way.
How many payments does PSLF require?
The form says 120 qualifying payments on Direct Loans while employed full-time by a qualifying employer. Neither the payments nor the employment have to be consecutive. The form also says the borrower has to be employed full-time by a qualifying employer when applying.
What counts as full-time for PSLF?
An average of 30 hours or more per week for the period being certified, whatever the employer calls full-time for other purposes. Vacation and FMLA leave count, volunteer time does not. Part-time work for more than one qualifying employer at once can count if the hours total 30 or more.
Which loans does the PSLF form cover?
Only Direct Loan Program loans, including Direct Consolidation Loans, that are not in default. The form says loans from the FFEL Program, the Perkins Loan Program or any other student loan program are not eligible for PSLF.
What if my employer has closed or will not sign?
Check the box at the end of Section 4 and use Section 5B. The form asks for a DD-214 or SCRA Status Report for military service, or W-2s for each calendar year or paystubs for each month for other employers. It says this adds significant time and that undocumented months are not certified.
What is TEPSLF?
Temporary Expanded PSLF, which the form says Congress authorized in March 2018. It covers borrowers otherwise eligible for PSLF whose only problem is that some or all payments were made under certain other repayment plans, such as Graduated or Extended plans. The form lists further conditions in Section 10.
What does the forbearance box in Section 2 do?
It asks for a forbearance while the application is processed, for borrowers who believe they already have 120 qualifying payments. The form says that time will not count if you are not yet eligible, and that without a forbearance, payments after the 120th are refunded or applied to other loans the Department holds.
Do I send all 16 pages?
No. The form says to leave out pages 5 to 16 when mailing or faxing it back. It also says pages 1 and 2 must be completed in their entirety.