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I'd like to "SKIP-A-PAYMENT" on the following loan(s) that I currently have with Family 1 for the month of:
Month ____________ Loan Type(s) ____ ____ ____
There is a $20.00 processing fee for each skip requested - each loan type is considered a separate request.* Please deduct this fee from my ___ Checking ___ Savings. I ___ have ___ have not had a Payment Skip in the last 12 months.
Your request HAS NOT been approved until you have been so notified by Family 1 in writing.
Signature_______________________________________ Member #_______ Date _________________
*Before applying, please verify that you have not been delinquent on any of your Family 1 loans in the last year. If you have been delinquent, you will be denied and the processing fee will be charged. | 
