Who must sign the form?

An authorized employer official (HR or payroll) must sign to attest to employment dates and status; a supervisor may sign if employer policy delegates authority.

Can I use an electronic signature?

Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention are satisfied.

When should I submit the certification?

Submit annually and whenever you change employers. Timely submissions reduce the risk of uncredited service when you apply for final PSLF forgiveness.

The federal PSLF employment certification does not generally require notarization; some employers or state rules may ask for notarization—verify with the employer.

How long should I keep the completed form?

Retain certified copies until forgiveness is granted and for several years after; follow applicable federal and state retention rules to support any future audits.

What if the servicer requests more information?

Provide payroll records, W-2s, or other employer documentation promptly to support the certification and avoid denial of qualifying service.

Electronic Signature
Templates
HR
Employee PSLF Form

Employee PSLF Form

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

EMPLOYEE PSLF FORM

Purpose: This form documents employment information needed to verify that an employee's position qualifies as public service for the purposes of federal student loan forgiveness administered under the Public Service Loan Forgiveness program. Employee completes the sections identified for the borrower. Employer completes the Employer Certification and signs to attest to the accuracy of employment dates, status, and duties.

Employee Information

Full Legal Name Residential Address

Phone

Email

Current Employer / Position Information

Employer Name Employer Address

Job Title

Department

Supervisor / Manager

Employment status: Full-time (typically 30+ hours/week) Part-time (less than 30 hours/week)

Average Hours Per Week

Employment Start Date

Employment End Date (if applicable)

Brief Description of Duties

Employer Certification (To Be Completed by Employer Representative)

The undersigned employer representative certifies, under penalty of law, that the information provided below is true and accurate to the best of the employer's knowledge. Employer attests that the employment reported above constitutes public service as defined for loan forgiveness purposes, and that the employee's duties, work hours, and employment dates are correctly reported.

Name of Certifying Official Title / Position of Certifying Official Employer Identification Number (optional)

Employer confirms (check all that apply):

Employee performed qualifying public service duties during the period reported. Employment meets full-time or equivalent standard as defined by employer (and consistent with program criteria). Dates of employment and hours reported are accurate and verified by official employer records.

Additional notes or clarifications (employer use):

Employment History (Prior Positions)

Employer 1 — Company Name

Primary Responsibilities Reason for Leaving

Employer 2 — Company Name

Primary Responsibilities Reason for Leaving

Education

Highest Degree Earned Institution Graduation Date

Professional References

Reference 1

Reference 2

Reference 3

Legal Disclosures & Authorization

At-Will Employment: Nothing in this form alters any at-will employment relationship unless an explicit, written agreement signed by authorized representatives of the employer and employee states otherwise.

Equal Opportunity: Employer certifies compliance with applicable equal employment opportunity obligations. This form is not an employment agreement and does not alter any statutorily required employment protections.

Authorization to Verify: I authorize my current and prior employers to release information necessary to verify employment and hours for the purposes of loan forgiveness certification and related administrative review. I understand false statements or misrepresentations may subject me to penalties under applicable law.

Applicant Certification: I certify that all information provided on this form is true, complete, and correct to the best of my knowledge. I authorize the employer named above to provide the requested verification and attestations.

Certification of Employee and Employer Representative

The employee must sign below to confirm the accuracy of the employee-provided information. The employer representative must sign below to certify the reported employment dates, status, and duties. Both signatures are necessary for this form to be accepted as employment verification for the Public Service Loan Forgiveness program.

Employee Printed Name:

By:

Date:

Employer Representative Printed Name:

By:

Date:

What the Employee PSLF Form Is

The Employee PSLF Form (Employment Certification for Public Service Loan Forgiveness) documents qualifying public-service employment periods and employer verification for borrowers seeking forgiveness under the federal PSLF program. It records borrower identity, employer legal name and EIN, employment dates, full-time status, and an employer signature. The completed form is submitted to the borrower’s federal loan servicer to count qualifying payments toward eventual forgiveness. Use it annually and whenever you change employers to avoid gaps in crediting qualifying service.

Why Accurate Certification Matters

Complete and maintain a properly filled Employee PSLF Form to ensure employment periods are credited toward Public Service Loan Forgiveness. Accurate, timely certification reduces processing delays and helps preserve qualifying payment credit.

Who Uses the Employee PSLF Form

The form is used by employees seeking PSLF credit and by employer representatives who verify employment details.

Public service borrowers who make qualifying payments and want PSLF credit
Employer HR, payroll, or authorized signatory responsible for verifying employment
Federal loan servicers that record qualifying service and payments

Loan servicers review certified forms when reconciling qualifying payments and when borrowers apply for final forgiveness.

Step-by-Step: Complete and Submit the Form

Follow these essential steps to certify employment correctly and avoid processing delays.

01

Prepare Info: Gather loan account number, employer EIN, and employment dates.
02

Fill Sections: Complete borrower and employer fields clearly and fully.
03

Obtain Signature: Get an authorized employer signature and date on the form.
04

Send to Servicer: Submit to your federal loan servicer per their upload or mail instructions.

Key Elements Included on the Employee PSLF Form

The form is structured to capture borrower identity, employer verification, employment details, and signature evidence required for PSLF crediting.

Borrower Details

Includes legal name, contact information, loan account number, and last four of the Social Security number to match the loan record exactly.

Employer Identification

Employer legal name and EIN are recorded so the loan servicer can verify public service or qualifying nonprofit status.

Employment Dates

Start and end dates (MM/DD/YYYY) indicate the specific period that may count toward qualifying service time.

Full-Time Status

The form asks whether employment was full time or the hourly equivalent; this affects whether the period counts in full or proportionally.

Employer Certification

An authorized employer representative attests to the employment details and provides printed name, title, and contact information.

Signature and Date

Employer signature (wet or compliant electronic signature) and date provide necessary attestation for servicer review.

Essential Data Points the Form Collects

Borrower Identity: Full legal name

Loan Identifier: Loan account number

Employer Identity: Employer legal name

Tax Identifier: Employer EIN

Employment Period: Start and end dates

Employer Attestation: Signature and printed title

How to Configure an Online Certification Workflow

Set up fields, signer order, and delivery so borrowers and employers can complete the form electronically.

Field	Place borrower, employer, date, and signature fields logically on the form.
Authentication	Use email plus SMS code or ID verification for stronger signer validation.
Signer Order	Require the borrower fill first, then route to employer for attestation and signature.
Audit Trail	Enable timestamps and IP capture to preserve signature evidence.
Delivery	Configure automatic copies to borrower and loan servicer when supported.

Typical Submission Flow for the Employee PSLF Form

A clear routing sequence helps ensure the form reaches the loan servicer with full verification and an audit trail.

Borrower Completes: Borrower provides loan and employment details and sends to employer.
Employer Verifies: Authorized employer official confirms dates and status and signs.
Return to Borrower: Borrower reviews the certified copy for accuracy.
Submit to Servicer: Send certified form to the federal loan servicer for crediting.

Technical Considerations for eSubmission and Storage

Use platforms that support common formats, secure authentication, and detailed audit trails for electronic certification.

File formats: PDF, DOCX supported
Integrations: Connectors for Google Workspace, Microsoft 365
Auth options: Email, SMS, KBA, SSO

Timing Guidance and When to Submit Certification

Timely certification prevents lost qualifying service. Submit annually and whenever you change employers to maintain an accurate record with your loan servicer.

Annual Certification:

Submit once per year to maintain continuous documentation with your servicer.

Change of Employer:

Certify when starting or leaving qualifying public service employment.

Pre-Forgiveness Review:

Submit all outstanding certifications before applying for final PSLF forgiveness.

Maintain Copies:

Keep certified copies until forgiveness is granted and for several years after.

Loan Servicer Rules:

Follow specific servicer upload or mailing instructions to avoid processing delays.

Key Milestones in Certification and Review

Track these sequential milestones from completion through servicer processing to ensure your service is credited.

01

Complete Form

Borrower fills and routes the form to employer for certification.

02

Employer Certification

Employer verifies employment details and signs the form.

03

Submit to Servicer

Deliver certified form per the servicer’s accepted channels.

04

Servicer Review

Servicer records qualifying service or requests additional evidence.

eSignature Vendors for Employee PSLF Form — Feature Snapshot

Compare basic pricing and feature availability for common eSignature vendors. signNow is listed first per platform comparison conventions.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Verify with vendor	Verify with vendor	Verify with vendor	Verify with vendor
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes

Real-World Examples of Certification Use

Practical examples show when and how employees and employers complete the certification to preserve PSLF eligibility.

Public School Teacher

A teacher completes the borrower section each year

Employer HR confirms full-time status for the school year
Annual certification keeps payment credit continuous until the teacher applies for forgiveness.

Public Defender

An attorney files certification after changing offices

New office HR completes verification with EIN and signature
The attorney maintains copies while the servicer reconciles qualifying payments.

Common Preparation Errors to Avoid

Using a trade name instead of employer legal name causes verification failures and processing delays.
Entering incomplete dates or wrong MM/DD/YYYY format leads to ambiguity about qualifying service periods.
Having an unauthorized staff member sign can invalidate the employer attestation and require re-submission.
Failing to keep a certified copy prevents you from responding to servicer requests for proof.

Risks of Incorrect or Missing Certification

Delayed Forgiveness: Processing delays reduce confidence in payment credit

Denied Credit: Incomplete or wrong data can lead to denial

Additional Documentation: Servicer may request payroll records or corrected forms

Lost Payments: Periods may not count toward forgiveness if unsupported

Administrative Burden: Re-submission requires time from borrower and employer

Privacy Risk: Improper handling of sensitive data can trigger compliance issues

Who Is Authorized to Sign the Employee PSLF Form

Borrower (Employee)

The borrower completes their section and signs when required; they are responsible for initiating certification and for maintaining copies until forgiveness is final.

Employer Representative

An authorized HR, payroll official, or supervisor must attest to employment details, provide employer EIN, and sign and date the form under employer authority.

Frequently Asked Questions About the Employee PSLF Form

Answers to common questions on signer authority, acceptable electronic signatures, timing, and recordkeeping to help avoid processing issues.

Need help? Contact support

Who must sign the form?
An authorized employer official (HR or payroll) must sign to attest to employment dates and status; a supervisor may sign if employer policy delegates authority.
Can I use an electronic signature?
Yes. Electronic signatures are valid under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, provided intent, consent, attribution, and record retention are satisfied.
When should I submit the certification?
Submit annually and whenever you change employers. Timely submissions reduce the risk of uncredited service when you apply for final PSLF forgiveness.
Do I need a notary?
The federal PSLF employment certification does not generally require notarization; some employers or state rules may ask for notarization—verify with the employer.
How long should I keep the completed form?
Retain certified copies until forgiveness is granted and for several years after; follow applicable federal and state retention rules to support any future audits.
What if the servicer requests more information?
Provide payroll records, W-2s, or other employer documentation promptly to support the certification and avoid denial of qualifying service.

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