Winter Skip-a-Payment Form I wish to skip a loan payment on one or more 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).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*MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920** 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.