Holiday Skip-A-Payment

Member Name/Primary Account Owner *

Primary account holder's name

Email Address *

Phone Number *

Phone *

Cell

Home

OtherOther

Required Information

I would like to skip the following payment on my loan. *

This month's payment

Next month's payment

OtherOther

Account Number *

Enter your member number

Loan Number *

Enter the loan suffix

Do you want the credit union to stop your automatic payment? *

Yes

Co-Borrower - if applicable

Co-Borrower's Name

If there is a Co-Borrower on your account we must verify their approval in writing, by e-mail or by phone.

Co-Borrower's Email Address

Co-Borrower's Phone Number

Phone

Cell

Home

OtherOther

Submit Application *

By clicking here you understand that if your skip payment/extension is approved, interest will continue to accrue during the month you choose to skip and may result in higher total finance charges on your loan. Skipping payments will extend the term of your loan. If you have already had a skip this year, you may not qualify. Mortgage loans and Visa loans are not eligible. This extension is subject to credit approval.

E-sign Disclosures - By submitting this form you are electronically submitting an application to skip a payment on your loan. By clicking here you are opting-in to receiving disclosures electronically as a convenience. Of course, you always have the option of applying in person or by mail. You are also advised that you have the legal right to obtain any records regarding your account in paper form. To get your records in paper form, please call us at 801-968-9011 or write to us at Hercules Credit Union, 3141 West 4700 South, Salt Lake City, Utah 84129.

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For Office Use Only:

Principal Balance

Next Due Date

Loan Officer Approval

If you are human, leave this field blank.

ONLINE BANKING LOGIN

Need a little extra cash for the Holiday?

Required Information

Co-Borrower - if applicable

For Office Use Only:

Hercules First Federal CU

Federally Insured

NMLS - #939496

Hercules CU Routing #:

324078776