Fee Payment

Personal Information

Loan Information

Fee Payment

For the $25.00 fee to skip my payment*

Withdraw from my savings Withdraw from my checking Pay by phone from another checking account

How you will pay the fee is required
Personal Information

First Name *

Last Name *

Address *

Address Line 2

City *

State *

Zip *

Phone *

Email *
Loan Information

Month to skip *

Type of Loan*

Loan Number*

Open-ended loans (including credit cards and Express Lines of Credit) and loans secured by real estate are not eligible. At least six payments must have been made since the loan was established. Only one payment skip is allowed in any 12-month period. Loans 30 days or more past due are not eligible. Any late fees due must be paid in conjunction with this transaction. Subject to underwriting approval.
Note: By skipping a payment, interest will continue to accrue, and your loan payoff will be extended by approximately one month.

Signature *

Clear Signature