Submit a Student Loan Client

Defaulted Federal Student Loan Services

Submit a client for Student Loan Services
Client Name *

First Name Middle Name Last Name
Birth Date *

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mobile Number
Company Referred From *
FSA Login *

Username Password
Last 4 SSN *
Family Size *
Adults and children including the client
Student Loan Providers Ask for TWO (2) references per applicant. Please provide the name, relationship, phone number and address of 2 references for the applicant. They have to be 18 + and can consist of family, friends, co workers etc. They CANNOT have the same address as each other or the applicant. *
Client Valid ID *

Cancel of
Client Paystub dated no more than 90 days if client is employed this is mandatory *

Cancel of
1 month worth of pay stubs. (4 if paid weekly | 2 if monthly or semi monthly | 1 if monthly) This is mandatory for REHAB clients

Cancel of
Does this client have an ACTIVE GARNISHMENT OR OFFSET ?? *
Total Student Loan Debt *
Estimated Monthly Payment *
Payment Type *

Standard Graduated PAYE REPAYE IBR ICR
Gross Annual Income *
Employer name and address *
Employment Type *

W2 Unemployed 1099/Self Retired
Payment Structure *

Weekly Biweekly Bi Monthly Monthly
Tax Filing Status *

Single Head Of Household Joint Married Separate Married
What service does your client need? Select all the apply *

Consolidation Forgivness REHAB ($197) IDR
Any additional notes you'd like to share for this applicant?

My Products

Fee Consolidation, income-driven repayment program and/or public service loan forgiveness one time Annual Fee

$ 97.00

Rehab Rehab one time annual fee

$ 197.00

Total

$ 0.00

Diamond Outsourcing, will process my client's file with the information that I have provided in this form.Diamond Outsourcing is NOT liable for any difference in my client's program if the information I have provided is incorrect. I understand that I am not eligible for a refund of the fee *

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Defaulted Federal Student Loan Services