Use whole dollar amounts

Exact amount: Report as:
$18.00 - $18.49 18
$18.50 19
$18.51 - $18.99 19

Financial Disclosure for Payments for Rehabilitation

The use of this online form is for Navient borrowers only.

Are you ready to complete your required form online?
Estimated completion time is 20-45 minutes.

Don't want to complete the form online? No problem, just download the form.

First, make sure your browser is secure.

To keep your information safe, your browser must support security standard TLS 1.2 or above. To check, press the button below:

Check Browser Security (opens in a new window)

If your browser passes the test, the "Protocol Support" section will say "Your user agent has good protocol support." If not, please use a current version of a different browser such as Safari, Google Chrome, Firefox, etc. Otherwise, the form may not display or operate properly.

Using a smartphone? Landscape mode works best.

If you're using a smartphone to complete the form, we suggest turning it sideways to landscape orientation before opening the form. This will make the form easier to fill and sign.

Prepare your data. Form expires in about 3 hours.

Please have all your information ready including your monthly income and expenses. You will need to complete this form within 3 hours or your security code will expire and all form data will be lost.

Get started!

Press the Open Form button to get started:

Open Form

Have a question or need help? Phone: (877) 291-7857.

choose country
At home in over 25 countries.
More than 7000 employees.
Over 55 operating companies.