Louisiana: Skip-a-Pay

Personal Information

Name*

First Name

Last Name

Email*

Account Number*

Loan Number*

Daytime Phone Number*

Method of Payment

Transfer from checking account Transfer from savings account

Checking Account Number*

Savings Account Number*

Authorization

By participating in Louisiana FCU’s Skip-A-Pay program, you request that Louisiana FCU defer your loan payments as indicated. You agree and understand that: 1) Loans must have originated 60 days prior to be eligible; 2) All co-signers of the loan must agree to the Skip-A-Pay program and sign the request; 3) FINANCE CHARGES will continue to accrue at the rate provided in your original loan agreement, during and after this time; 4) Deferring your payment will result in your having to pay higher total FINANCE CHARGES than if you made your payment as originally scheduled; 5) The payment deferral will extend the terms of your loan(s); 6) You will be required to resume your payments the following month. If you elected GAP or Warranty Coverage, the coverage will not be extended beyond the original maturity date. All deferrals are subject to Louisiana FCU approval. Excludes all real estate loans, tuition loans, promotional check loans and credit cards.

Does this loan include a joint signer/co-signer?*

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Borrower's Signature*

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Co-signer's Signature*

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Date/Time*

Month / Date / Year

Are you recently unemployed as a result of COVID-19? Please check this box and upload a copy of your proof of unemployment.

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