Skip-A-Payment Request Form

✓ YES! I could use some extra cash this holiday season. Please defer my eligible consumer loan payment for either December 2025 or January 2026.

I understand that all terms and conditions of my loan agreement will remain in effect, except that a regular monthly payment will not be required during the month that I select (either December 2025 or January 2026). Finance charges will continue to accrue during the skipped month, which will increase the total finance charges paid over the life of the loan and extend the repayment schedule. A non-refundable $20 processing fee will be charged per loan skipped.

The Family Credit Union reserves the right to deny this request if my accounts are not in good standing, my loan is or has been past due within the last 12 months, the first full contracted payment has not yet been made, or if the loan type or terms do not qualify. (See exclusions below.)

I wish to defer my consumer loan payment for the month of (choose one):

December 2025January 2026

Requests must be submitted via the form below at least two weeks prior to the monthly due date of the loan. This skip payment promotion is not available for credit cards, mortgage loans, home equity lines or loans, share draft resolution loans, workout loans, any loan with a term longer than 84 months, or any loan in an active payment arrangement.

Full Name

Last 4 Digits of Account Number

Loan Type

Preferred Branch (required)

Phone Number (required)

Email (in the event that we need to contact you)

I understand the approval guidelines and restrictions listed above for this payment modification request.

Signature

If you don't hear from us, your payment skip will be approved and processed. We will only contact you if we need more information or if we are unable to approve your request.