Skip-a-Pay Yes! I want to take advantage of the Skip-a-Pay

Skip-a-Pay
Yes!
November 1 - December 31, 2014
I want to take advantage of the Skip-a-Pay
offer. Please defer my loan payment(s) for 1 month.
*Excludes Real Estate loans, loans less than 6 months old, subprime (funded through capital
lending), and any past-due loans. $30 service fee per loan.
Name____________________________________________________________
Address__________________________________________________________
Social Security Number______________________________________________
Account Number___________________________________________________
Home Phone______________________________________________________
Work Phone_______________________________________________________
I want to use Skip-A-Payment on the following loan(s): #__________________
________________________________________________________________
I would like the service fee ($30 per loan) to be taken from:
q
Checking
q
I have enclosed my check for $___________ for the service fee.
Make checks payable to: Fort Financial Credit Union
q
Savings
I (We) understand the terms and conditions of my (our) loan agreement will apply except
that there will not be a regular monthly payment required during the month selected as
my (our) Skip-A-Payment month. This month will be determined by the date this form
is returned to Fort Financial CU. By deferring my loan payment, I (We) understand that
this will extend the loan payment term. I (We) understand that finance charges will continue to accrue during the deferral period. I (We) also understand that Fort Financial CU
reserves the right to terminate this offer if my (our) financial status changes prior to the
actual Skip-a-Payment month requested. Offer expires December 31, 2014.
Signature:______________________________________________ Date:___________
Co-Signer/Co-Borrower Signature:______________________________ Date:___________
Co-Signer/Co-Borrower must sign this agreement.
FOR OFFICE USE ONLY:
m Due date extended
m Final Pmt date
m Insurance date
m Charge fee
m ACH Loan Payment stopped