2025 Skip-a-Pay Program Post Form

First & Last Name^*
Member Number^*
Phone Number^*
Email Address^*
Loan Description^*
Capital Credit Union Account Number to take $40 Skip-a-Payment fee from:^*
Account Type^*
Disclosure Agreement^*		I have read and agree to the disclosure below.
Fee Acknowledgement^*		I acknowledge there is a $40 fee to skip a payment and that I have sufficient funds in my Capital Credit Union account(s) to cover this fee.
E-Signature^* By typing your name in this box, you acknowledge your electronic signature for this transaction and agree to the terms and conditions of our Electronic Communication & eSignature Disclosure.

DISCLOSURE: By submitting this application, I authorize Capital Credit Union to skip the payment noted above. I understand that interest charges will continue to accrue on my loan and that by skipping a payment, it will extend the number of months that it will take to pay off my loan. I understand that skipping a payment may affect my loan's GAP (Guaranteed Asset Protection) coverage. This application must arrive at Capital Credit Union five days before the due date of your loan in order to be processed without a late payment. Loan must be open for 90 days, current and all accounts in good standing in order to qualify for Skip-a-Payment. A maximum of two payments per qualifying loan may be skipped within a 12-month period and one monthly payment must be made between skips. All requests are subject to approval. Capital Credit Union reserves the right to deny this offer for any reason. Other restrictions may apply.

Please only click the 'Submit' button once.