Texas DPS Credit Union
Skip-A-Payment Form
Date:
MEMBER INFO
First & Last Name:
Account #:
Loan #:
Day Phone#:
Email:
REQUEST
Request a Skip-A-Payment for the month of:
Please state the reason for the Skip-A-Payment requet:

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ADMINISTRATIVE FEE PAYMENT
Loan payment will not be changed until this form is signed and returned with method of payment.
Please deduct the $25 Skip-A-Payment fee (per loan) from my Texas DPS Credit Union:
Savings
Checking
Check Enclosed
TERMS, CONDITIONS, AGREEMENT

All requests to Skip-A-Payment are subject to credit union approval. To request a Skip-A-Payment, members must have at least 6 months' payment history since origination of loan or last Skip-A-Pay granted, loans cannot be 30 or more days' delinquent, and all accounts at the credit union must be in good standing. Excludes mortgage, home equity, home improvement, credit cards and one-time payment term loans. A fee will be assessed for each Skip-A-Payment request. The Skip-A-Payment Request form must be received at least 5 business days before the loan payment due date. The $25 Skip-A-Payment fee must be paid prior to payment date and cannot be rolled into the loan balance. In the event of a claim, Guaranteed Asset Protection (GAP) may be affected. Other restrictions may apply.

 

By signing below, I understand the interest will continue to accrue during the deferred period. I understand this will extend the term of my loan and agree with the terms and conditions of the Skip-A-Payment program.
Borrower's Signature:
Date:
Co-Borrower's Signature:
Date:
RETURN FORM

Mail To:
P.O. Box 15346

Austin, TX 78761

Fax To:
1(512)459-3533
 
Office Use Only:
Approved
Denied
Credit Committee / Loan Officer:
Date:
Comments:
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NCUAFederally
Insured by
the NCUA
Equal Opportunity LenderEqual
Opportunity
Lender

Texas DPS Credit Union | 621 W. St. Johns Ave | Austin, TX 78752
Mailing Address | PO Box 15346 | Austin, TX 78761
Toll Free 1(877)252-9199 | Austin (512)452-5211

Routing# 314977324