Author: Lori Rathbun

BLOOMINGTON POSTAL EMPLOYEES CREDIT UNION
SKIP-A-PAY APPLICATION

Member Name: ____________________________________ Account Number: ___________________
Daytime Phone:____________________________________ Loan Number: ______________________
Month(s) to Skip: _____________________________________________________________________
Reason: _________________________________________________________________________________
_____________________________________________ ______________________________
Member Signature Date
______________________________________________________ ____________________________________
Member Signature Date
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Please circle the appropriate answer to the following questions:
Do you have any loans that are currently more than thirty (30) days past due? YES or NO
If yes, name of creditor and how many days? _____________________________________
_________________________________________________________________________
Have you made six (6) full months of payments since the beginning of this loan? YES or NO
3. Is this loan paid by automatic payments or payroll deduction? YES or NO
Restrictions: Loan cannot currently be more than thirty (30) days delinquent. Six (6) full months of payments must be received prior to the first payments being skipped. Only two (2) payments may be skipped per calendar year and may not be consecutive months. Not available on VISA credit card balances. Not available on loans with an outstanding balance of $30,000.00 or higher. Not available on loans with a remaining term of 60 months (5 years) or greater. All signed individuals on the original loan agreement must sign the application.
Disclosure: Fee is $25.00 for first skipped month and $30.00 for second skipped month per loan per year, and must be paid in full before the application can be processed. The fee does not apply towards the principal or interest on the loan. Skipping a payment will extend the term of your loan. Interest continues to accrue during the time the payments are skipped. Payroll deduction funds may be redirected into your account for the payment(s) skipped. You authorize Bloomington Postal Employees Credit Union to obtain credit reports in connection with this request.
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For Credit Union Use:
________ Fee Charged ____Due date changed from _________ to _________ ___Change Payroll
Comments:______________________________________________________________________________________________
Approved by: ____________________________________ Date:_____________________