Skip-A-Pay Request Form

Skip-A-Pay Request Form
Name*

First NameLast Name
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
I understand and agree to the following requirements: *

Yes
- A separate Skip-A-Pay request form must be submitted for each loan I wish to skip a payment on.
- My loan must be current, with no prior extensions, and at least six (6) months old.
- Credit Cards and Real Estate secured loans are not eligible.
- There is a $40.00 processing fee for each Skip-A-Pay request that is approved.
- The processing fee must be available in the designated account at the time my request is submitted.
- Skip-A-Pay requests must be submitted at least 15 days before the loan due date to be eligible.
Loan Details
Account Number*
Loan Suffix*
Select Month to Skip Payment:*
Please debit the processing fee from:
Account Number*
Account Suffix:*

Savings S1Savings S20Checking S9Checking S19
I understand that skipping my loan payment for one month will delay the payoff and the finance charges on the unpaid loan balance will continue to accrue. By signing this amendment to my loan agreement, I authorized Upward Credit Union to change my payment schedule. I also agree to pay a $40.00 processing fee.**

YesNo
Response Time:
A loan officer will send you a text notification approximately five (5) business days after you submit your Skip-A-Pay request to inform you whether your request has been approved.
Signature*

Clear
Date*

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
*$40.00 fee per loan. Limit of one skipped loan payment every 12 months per member. Interest will continue to accrue. Loans must be current with no prior extension or have not been delinquent more than twice over 30 days. Loans must be at least six (6) months old. All requests MUST be in writing and skips will ONLY be placed on loan suffixes indicated. If your loan payments are normally paid by payroll deduction, understand that the funds will still be deducted but instead of being applied to the loan it will remain in the transfer account. This promotion cannot be used for Real Estate Secured Loans or Visa® Cards. Federally insured by NCUA.
Should be Empty:

Skip-A-Pay Request Form

Loan Details