Winter Skip-A-Pay

By completing this form, I confirm that I want to skip a payment on one or more of my loans. I understand that there is a $20.00 processing fee for EACH loan payment that is skipped. I realize that interest will continue to accrue on my loan during the month that the payment is skipped and the loan term will be extended by one month each time that I skip a payment. My credit rating will not be negatively affected. If skipped, auto loans covered by GAP protection may be required to make up any skipped payments in the event of a covered claim. (See any loan officer for details).
Is the loan you intend to use Skip-A-Pay for a Home Equity?*
- Yes
- No
Please note: Home Equities don't qualify for the Skip-A-Pay program.

Is the loan you intend to use Skip-A-Pay for Credit Line or Credit Card?*
- Yes
- No
Please note: Lines of Credit and Credit Cards don't qualify for the Skip-A-Pay program.

Is the loan you intend to use Skip-A-Pay for at least 6 month old?*
- Yes
- No
Please note: Loans should be at least 6 months old to qualify for the Skip-A-Pay program.

Choose ONE month only:*
- November
- December
- January
Please deduct the fee from my*
- Savings Account
- Checking Account
Name*
Account Number*
Loan Number(s) or Loan Payment Amount(s)*
Please separate each Loan Number or Loan Payment Amount with a comma (,).
Signed by*
Co-Borrower / Co-Signer
Date*
MM
DD
YYYY
** Restrictions may apply. Mortgages, Credit Cards, and open-end loans are excluded from this offering. To qualify your loan must be an existing loan at least 6 months old and be current. All parties to the loan must agree to the extension.
Notes

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