Skip-a-Payment Offer good for skipping one month’s payment per eligible loan during a 12-month period. All CUA loans must be current and accounts in good standing. Must have a minimum of $25 in a share account as well as funds for a $25 fee for each loan payment skipped. Requests will be processed for the next due date. Loan must have 6 months of on-time payments prior to requesting a skip-a-pay. Name Member Number Phone Number Email Address CUA Account Number to take $25 Skip-a-Payment fee from Loan Account Number(s) *No Credit Cards or Real Estate loans* Agree to Disclosure I have read and agree to the disclosure Fee Acknowledgement I acknowledge there is a $25 fee to skip a payment Signature (enter your name) Prove you're not a robot. Disclosure By accepting, you agree to skip your next payment due to Credit Union of America on the indicated loan number for a fee of $25 to be collected immediately from the Credit Union of America transaction account listed above. The terms and conditions of your loan agreement will apply except that there will not be any payment required for approved requests during the deferral period set forth in this agreement. Thereafter, you must make your regular scheduled payments. Finance charges will continue to accrue during the deferral period resulting in payment of higher finance charges and an extension of the original loan term. If you purchased GAP coverage with your loan, payment of claims may be affected. Refer to your GAP Agreement for coverage restrictions. By submitting this request on behalf of all borrowers, you represent that all borrowers are aware of this skip payment and consent. If you use an automatic transfer method from another financial institution other than Credit Union of America for your payment, it is your responsibly to contact the sending financial institution to defer the upcoming transfer. Any payments received will be posted to the loan regardless of due date. Requests must be submitted at least five days prior to due date. A confirmation will be sent to the email address on file once the skip a pay has been approved and scheduled. Other terms and conditions may apply. Offer may be terminated at any time.