Skip A Payment Form * Required Fields Personal Information First Name: Last Name: Last Four Digits of Member Number: Last Four Digits of Social Security Number: Date of Birth: Date of Birth: Month Month... January February March April May June July August September October November December / Date of Birth: Day Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Date of Birth: Year Year... 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 Preferred Telephone Number: Email: Please provide any information pertaining to this Skip A Payment that may be relevant for review:: Preferred Method of Contact: Email Phone Loan Information Loan Type: Select... Vehicle Loan Credit Card Personal / Signature Loan Share Secured Loan Smart Start Loan Loan Suffix: Skip Month and Year: Loan Information #2 Loan Type: Select... Vehicle Loan Credit Card Personal Term Signature Loan Share and Share Certificate Loan Smart Start Loan Loan Suffix: Skip Month and Year: Loan Information #3 Loan Type: Select... Vehicle Loan Credit Card Personal/Signature Loan Share Certificate Secured Loan Smart Smart Loan Loan Suffix: Skip Month and Year: Which account would you like to debit your Skip A Payment Fee from? Checking Savings N/A Skip A Pay Authorization FormTampa Bay Federal offers the Skip A Pay feature as follows: I will be allowed to make no payment for one month of my choosing without being considered delinquent on my plan (“skip period”). Program does not include First and Second Mortgages, Home Equity Loans, Manufactured Home (Triad) Loans, or any loan with an active CPI (Collateral Protection Insurance) Policy added on. To be eligible for the Skip A Pay Program All your share and loan accounts with Tampa Bay Federal must be current and in good standing, your loan must be active for six months, and completed Authorization Form four (4) days prior to due date. Interest and finance charges will continue to accrue during the skip period. A fee (see fee schedule) per consumer loan is imposed for exercising the skip feature. I understand and agree that this fee will be taken from my share savings account; therefore, I must have sufficient funds in order to process the skip payment request. This fee is a finance charge, and will increase my Annual Percentage Rate (APR) on my loan. My required minimum monthly payment will start again beginning in the month immediately following the skip period and will continue as originally scheduled. I understand that I can only exercise this feature once in a calendar year. Any additional payments resulting from the exercise of the skip payment feature will not be covered by credit insurance and/or GAP. I further understand that exercising the skip payment feature will extend the time it takes to pay off my plan in full. I understand all Skip-A-Payment requests are subject to final approval from the Credit Union. ACH originations or Automatic Funds Transfers will continue to post to savings or checking account, however they will not post to my loan(s). Thank you for using our Website application. By placing this Web request, you certify that all statements made are true and complete. A credit union representative will contact you if any additional information is needed to process your request or if your request is denied. Fees and qualifications may be waived in the event of an emergency declaration. Terms and Conditions Agreement: By clicking here, I indicate I have read and agree to the Terms and Conditions above. Member Signature : Security Code: Security Code
Skip A Payment Form * Required Fields Personal Information First Name: Last Name: Last Four Digits of Member Number: Last Four Digits of Social Security Number: Date of Birth: Date of Birth: Month Month... January February March April May June July August September October November December / Date of Birth: Day Day... 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Date of Birth: Year Year... 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042 2043 2044 Preferred Telephone Number: Email: Please provide any information pertaining to this Skip A Payment that may be relevant for review:: Preferred Method of Contact: Email Phone Loan Information Loan Type: Select... Vehicle Loan Credit Card Personal / Signature Loan Share Secured Loan Smart Start Loan Loan Suffix: Skip Month and Year: Loan Information #2 Loan Type: Select... Vehicle Loan Credit Card Personal Term Signature Loan Share and Share Certificate Loan Smart Start Loan Loan Suffix: Skip Month and Year: Loan Information #3 Loan Type: Select... Vehicle Loan Credit Card Personal/Signature Loan Share Certificate Secured Loan Smart Smart Loan Loan Suffix: Skip Month and Year: Which account would you like to debit your Skip A Payment Fee from? Checking Savings N/A Skip A Pay Authorization FormTampa Bay Federal offers the Skip A Pay feature as follows: I will be allowed to make no payment for one month of my choosing without being considered delinquent on my plan (“skip period”). Program does not include First and Second Mortgages, Home Equity Loans, Manufactured Home (Triad) Loans, or any loan with an active CPI (Collateral Protection Insurance) Policy added on. To be eligible for the Skip A Pay Program All your share and loan accounts with Tampa Bay Federal must be current and in good standing, your loan must be active for six months, and completed Authorization Form four (4) days prior to due date. Interest and finance charges will continue to accrue during the skip period. A fee (see fee schedule) per consumer loan is imposed for exercising the skip feature. I understand and agree that this fee will be taken from my share savings account; therefore, I must have sufficient funds in order to process the skip payment request. This fee is a finance charge, and will increase my Annual Percentage Rate (APR) on my loan. My required minimum monthly payment will start again beginning in the month immediately following the skip period and will continue as originally scheduled. I understand that I can only exercise this feature once in a calendar year. Any additional payments resulting from the exercise of the skip payment feature will not be covered by credit insurance and/or GAP. I further understand that exercising the skip payment feature will extend the time it takes to pay off my plan in full. I understand all Skip-A-Payment requests are subject to final approval from the Credit Union. ACH originations or Automatic Funds Transfers will continue to post to savings or checking account, however they will not post to my loan(s). Thank you for using our Website application. By placing this Web request, you certify that all statements made are true and complete. A credit union representative will contact you if any additional information is needed to process your request or if your request is denied. Fees and qualifications may be waived in the event of an emergency declaration. Terms and Conditions Agreement: By clicking here, I indicate I have read and agree to the Terms and Conditions above. Member Signature : Security Code: Security Code
