Energize Credit Union - Loan Skip Request

You may Skip up to 2 Payments in a 12 Month period. The Skipped Payments are added to the end of the Loan Term.

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Member Information

Member Name

Member Number

Loan Number

Email

Phone

Month

Per Loan Fee of $20 will be deducted from Savings. Coop Payroll Deduct does not change.

E-Sign Disclosure

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I have read, understand and agree to the terms of application.

Acknowledgement for Skipping a Payment

Signature

Signature Date

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