Skip Payment Form

Yes, I'd like to Participate in the deferred payment program for the month of: *

December 2021 January 2022

I understand there is a $45.00 processing fee per each loan request in which a payment is deferred. The $45.00 is required to be in your Central State savings or checking account at the time of the Skip A Payment request. You must apply 10 business days before your payment is due. You can make a Deposit from your other bank to Central State CU by phone, please call 1-800-675-5114 for assistance.

The following Loan Types are allowed the deferred payment program:
Autos, Boats, Motorcycles, Jet Ski's, All Terrain, RV's, Signature and Secured Loans

The fee: *

will be deducted from my CSCU Savings when this notice is received. will be deducted from my CSCU Checking when this notice is received.

This offer does not apply to Real Estate, HELOCs, Lines of Credit and credit cards.*

How many loans are you applying to the deferred payment program application? *

Account *

Loan ID # *

Loan *

Account *

Loan ID # *

Loan *

Account *

Loan ID # *

Loan *

Account *

Loan ID # *

Loan *

Account *

Loan ID # *

Loan *

I understand that by deferring my monthly payment(s) on my loan(s) (i) the final payment date will be extended, (ii) I will be charged more interest over the life of the loan and (iii) the final payment amount will change due to the accumulated interest. (iv) approval of this request to skip-a-payment is in the sole and absolute discretion of the Credit Union. I understand that any GAP policies I may have purchased will only cover an additional 2 (two) months of extended payment(s), therefore, should my deferral of payment increase the number of payments by more than 2 additional months, then the GAP policies will not cover any of the payments in excess of the 2 additional months. Members must be in good standing to qualify. All Loans must be current. Loans that are not over 12 months old do not qualify. New Loans with deferred/future due dates do not qualify. Exceptions - See VP of Lending, AVP of Collections, CEO.

***ALL SIGNERS ON LOANS MUST SIGN THE DEFERMENT REQUEST!***

Borrower Signature *

I understand this is a legal representation of my signature. Clear

Date *

Name *

First Name Last Name

Email *

example@example.com

Phone Number *

Please enter a valid phone number.

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Do you have a Co-Borrower? *

Yes No

Co-Borrower Signature *

I understand this is a legal representation of my signature. Clear

Date *

Co-Borrower Name *

First Name Last Name

Loan #1

Loan #2

Loan #3

Loan #4

Loan #5