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/ Federal Perkins Loan Program / William D. Ford Federal Direct Loan Program / Teacher Education Assistance for College and Higher Education Grant Program WARNING: Any person who knowingly makes a false statement or misrepresentation on this form or on any accompanying documents will be subject to penalties which may include fines, imprisonment or both, under the U.S. Criminal Code and 20 U.S.C. 1097. READ THIS FIRST: This is an application for a total and permanent disability discharge of your.

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