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Recipient Data Form

Enter you name and NC LEAF ID Number

Your NC LEAF ID Number is your NC Bar License Number with your 4 number PIN at the end (e.g. 12345-1234). If you need your PIN resent, please email us.
Name(Required)

Please complete in full.

Home Address

Add State or Federal Agency, Program, or Employer where you work.
Select all the apply.
Hold Ctrl and click on a PC or command and click on a Mac to select multiple locations.
Work Address

Preferred Email

All of my loans are currently in forbearance:
Some of my loans are currently in forbearance:

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MM slash DD slash YYYY

217 East Edenton Street
Raleigh NC 27601-10155

info@ncleaf.org

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