Public Service Loan Forgiveness Information Form

If you would be willing to speak to our office about Public Service Loan Forgiveness, please provide the information requested below.

* Starred fields are mandatory in order to process your submission.

Intake Information

*Do you currently have federal student loans? Yes No

*Are you currently employed by the State of Washington? Yes No

*Do you currently work, or have you in the past worked, in public service? Yes No

*Are you considering a position in public service in the future? Yes No

*Do you have plans to pursue Public Service Loan Forgiveness in the future? Yes No

Occupation:

*Last Name:

*First Name:

Middle Name:

*Contact phone:

*Contact e-mail address:

*Confirm e-mail address:

Privacy notice and disclaimer

In filling out this form, I understand that the information I provide and any response to it from the Attorney General's Office will become a public record and that under state law, public records are subject to public records disclosure requests. Under some circumstances, I recognize that my name, email address, and phone number may be disclosed to or seen by other people in response to a public records request.

Please keep this in mind when providing personal information to the Attorney General's Office, and please do not provide information such as Social Security information, credit and bank account numbers, and medical and other financial information.

How much personal information you provide to the Attorney General's Office is up to you. To learn how we safeguard your personal information, please read our Privacy Policy.

Yes, I Understand