27k Student Loan Repayment Program Application for Individual Participants

This is the individual application for payments under the Student Loan Repayment Program. Before you begin, please review the information on the website to ensure that you meet all eligibility criteria and have all necessary loan documentation in advance.

IMPORTANT: An incomplete application will not be reviewed. You may ONLY submit one application. Please ensure you have all the necessary documentation before you submit your application.

Participant Contact Information

First Name

Last Name

Valid Primary Email Address

Valid Secondary Email Address

Note: Your primary e-mail address should be an e-mail address that will not change if your place of employment changes. An invalid, incomplete, or misspelled e-mail address may affect your ability to receive timely payments.

Date of Birth

Please provide your correct Personnel Identification Code (PIC) below. This will allow your district to verify your employment information per MCL 388.1627k and help the 27k team complete the application review process. Please note that failure to provide an accurate PIC number may result in a delay or denial of your application. PIC

PLEASE NOTE

If you are unsure of your PIC, visit the MOECS public search tool here: Michigan Online Educator Certification System. (Search your name, select your credential number, your PIC will be listed).
If you are not listed in the MOECS public search, please contact your school’s or district’s HR department or administrative office to obtain your PIC.

District Information

Begin typing your district name and select your official district from the drop-down menu. Be sure the field for District Code is filled before proceeding. District Name

District Name

District Code

If needed, please visit Entity Quick Search to search for your official district name, which will also show you its District Code.

Assurances

I certify I currently owe federal student loans.

I certify I am eligible for the federal public service loan forgiveness (PSLF), and I am under, pursuant to federal law, a payment plan that makes eligible payments.

I certify I am enrolled in an income-driven repayment plan. If my loan is not eligible for income-driven repayment, I understand that I am exempt from this requirement.

I certify I may only receive funding through the Student Loan Repayment Program only if I continue to meet the criteria of an eligible participant. I understand that if I continue to accept payments while I am no longer eligible for the program, I am responsible for returning those funds.

I understand I will be required to annually certify to the department that I made payments towards my eligible federal student loans with the funding received from the Student Loan Repayment Program. If at any point I leave the program, I will notify the department of the date I left the program.

I certify I will notify the department of any increases or decreases in my monthly payment towards my eligible federal student loans.

I certify I have not already received funding from the Student Loan Repayment Program for any of the months below. If I have already received funding from the Student Loan Repayment Program for any of the months below, I have recorded $0 for those months. If any of these months were in a deferment or forbearance status, I have recorded $0 for these months.

Loan Information

I certify that I am eligible for reimbursement payments under the Student Loan Repayment Program for the following past months and amounts:

October 2024 Exact Payment
November 2024 Exact Payment
December 2024 Exact Payment
January 2025 Exact Payment
February 2025 Exact Payment
March 2025 Exact Payment
April 2025 Exact Payment

Total PSLF Monthly Exact Payments

PLEASE NOTE

If the exact payments listed above do not reflect the monthly payment amount shown in your uploaded documentation, your application may be denied.
If you did not enter $0 for months that were in deferment or forbearance, your application may be denied.
If your monthly payment was $0.00, enter $0.00 above.

I certify that I am eligible for reimbursement payments under the Student Loan Repayment Program for the following months and amounts that remain in this fiscal year:

May 2025 Estimated Exact Payment
June 2025 Estimated Exact Payment
July 2025 Estimated Exact Payment
August 2025 Estimated Exact Payment
September 2025 Estimated Exact Payment

Total PSLF Monthly Estimated Payments

File Requirements

Please upload any and all documents or images showing your current and past student loan payments made under PSLF, matching all amounts entered for payments you have made by the date of application. You may upload documents or images that have ONLY the following file formats: .jpg, .png, .gif, or .pdf. No Word or Excel files will be reviewed by MDE.

Drop files here or click to upload

File Name	File Size

Signature and Date

Fraud Warning

I certify the information provided in this application is true and complete to the best my ability. I understand providing false information will disqualify me from participating in the Student Loan Repayment Program and may require repayment of funds.

Please enter your full name below, or the name of the person preparing this application on the applicant’s behalf. Signature

Date

Your application will only be submitted once you hit the submit button below. If your application is successfully submitted, you will receive an email confirmation shortly. Please note that an application that has not been submitted will not be reviewed by MDE.

27K Student Loan Repayment Program Certification

Participant Contact Information

First Name

Last Name

Date of Birth

PIC

Primary Email

District Information

District Name

District Code

Please select an option below:

I would like to report a change in my monthly loan payment

I would like to report that I am no longer eligible for the program due to changes in my eligibility status

I would like to report that I have no changes to my monthly loan payment amount or program eligibility

Certify Change in Monthly Payment

By submitting this report, I certify to the department that I am reporting a change in my monthly payment since the time of submitting my application.

Record your updated monthly payments as shown on your statements for the following months on the table below. If your loan is in forbearance or deferment, enter $0.00. However, if your loans have been paid off or forgiven, please select the “I would like to report that I am no longer eligible for the program due to changes in my eligibility status” option above.
This amount may only be the amount due or expected by your loan servicer. Please note that anything you pay over the expected loan payment amount is considered voluntary and not covered under the Student Loan Repayment Program.

Month	Payment ($)
May 2025	May payment required Invalid amount
June 2025	June payment required Invalid amount
July 2025	July payment required Invalid amount
August 2025	August payment required Invalid amount
September 2025	September payment required Invalid amount

File Drop-Box

For this section, you must submit proof of your new and expected loan payments.

Your document should:

Include your name to confirm your identity.
Clearly state the monthly amount due for the following months claimed above.

For more detailed instructions, please review the Student Loan Documentation Guidance (PDF).

File requirements:

You may upload documents or images that have ONLY the following file formats: .jpg, .png, .gif, or .pdf. No Word or Excel files will be reviewed by MDE.

Upload Files:

Drop files here or click to upload

File Name	File Size

Signature

Please provide your signature and submit your report to the department.

Assurances

Assurances I certify the information is true and complete to the best of my knowledge
I understand the consequences for knowingly providing fraudulent information to the Michigan Department of Education