Skip-A-Payment Request

* indicates a required field

Want to Skip-A-Payment? No problem. Please review the following guidelines and complete the form and enter your name below.

The program applies only to The Police Credit Union Vehicle, Personal, and Savings Secured Loans
The requested loan has been open for at least six (6) months
All of your accounts with The Police Credit Union must be current and in good standing
The request must be submitted at least five (5) business days before the payment is due for processing
You are limited to one skipped payment per loan during each calendar year
Interest continues to accrue on your loan in the month of the skipped payment
There is a $25 fee per loan, per occurrence that will be deducted from your Savings/Checking account

Complete the form below and enter borrowers' name(s)
*Borrower Name
Co-borrower Name
Co-borrower Name
*Member Number
*Contact Phone Number
*Loan Account Number
*Loan Type
*Month You Would Like to Skip-A-Payment
*Current Loan Payment Method	Cash/Check Automatic transfer from an account at The Police Credit Union Payroll Deduction Bill Pay or another online payment service
Please Note: For payments you generate (for example, payments you set up with a bill payment service or another payment service) you are responsible for stopping the payment for the month you enact Skip-A-Pay. Any automatic transfers generated by The Police Credit Union will be suspended for the Skip-A-Pay.
*Transfer $25 fee from	Savings Checking

By entering my name in the field below, I/we understand the eligibility requirements listed above and request to skip the next payment due on the loan referenced above. Upon approval I/we agree to pay a non-refundable application fee of $25 from The Police Credit Union account indicated. Skip-A-Pay approval is at the sole discretion of The Police Credit Union. If for any reason The Police Credit Union does not grant approval, I/we will hold The Police Credit Union harmless from any and all consequence resulting from that decision. I/We understand that skipping a payment will extend the term of my/our loan, interest will continue to accrue, total finance charges will increase and does not change or alter any other terms and conditions of the original loan agreement. I/We agree to all the provisions of the Skip-A-Pay program as described in this disclosure. All parties to the original loan agreement must enter their name below and date.

*Borrower's Name	*Date
Co-Borrower's Name	Date
Co-Borrower's Name	Date

INTERNAL USE ONLY
Rec'd _____ /_____ / _____	Received By ____________________________________________________________________
Open Date ___________	Completed By ____________________________________________________________________