Loan Extension Request

Name*

Account Number*

Email Address*

Home/Cell Phone*

Work Phone*

Length of Extension*

LoanType*

Reason for Extension*

Explain why you are experiencing a financial hardship, please be detailed.

Dislosure

I understand that I will be required to make the payment(s) deferred prior to my final loan payoff and that the interest will continue to accrue at the contract rate including the month(s) that I have chosen to defer. This payment deferral will result in an extension of the maturity date and will increase the finance charges disclosed on the original promissory note. This deferral will not extend insurance products purchased outside of the credit union.

I agree to the disclosure statement above.