AREA CREDIT UNION
1401 Fairfax Road, E-100
Kansas City, Ks. 66115-1489
Phone: 913-371-1345 Fax 913-371-3318

SKIP-A-PAYMENT FOR CHLDREN'S MIRACLE NETWORK

For a suggested dontation of $ 10.00 you can skip your December OR January loan payment. Fill out the Form below and we'll set up your account to skip your next payment AND donate your $ 10.00 to the Children's Miracle Network (CMN), a credit union sponsored organization, that raises funds for kids who are sick, and provides hospital care to children based on need and not the ability to pay. Contributions raised stay within the local communities, helping kids through the KU Medical Center and Children's Mercy Hospital.

When your payment is skipped your loan term is extended, your interest will accumulate until the next payment and you resume payment the next due date. This "Skip a Payment" Program is valid for one (1) month's worth of payment per loan. A separate $ 10.00 Skip A Payement donation is requested for EACH loan payment you desire to skip. Also, the payment you wish to skip must fall no later than January 31, 2010. (You must make your 1st payment before you can skip one and your payments must be current 3 months prior to the month you wish to skip).

Name_____________________________________________________
Address _____________________________________________________________________________________________________
Day Phone # _________________________________ Account #____________________________
(December or January)
LOAN # 1    Skip Due date _________________________
LOAN # 2    Skip Due date _________________________
LOAN # 3    Skip Due date _________________________
$10.00 Skip A Payment donation (make checks out to the Area Credit Union)
(check one)   ( ) enclosed   ( )please deduct from my shares

SIGNATURE REQUIRED___________________________________________
Return this origianl SIGNED form to our office.

To ensure your request is processed on time, we must receive it at least FIVE DAYS BEFORE the payment date you wish to skip. Payments may not be skipped on mortgage or past due loans.

The loan you wsh to skip a payment on must have been current 3 months prior to the skipped payment.
NO PHONE OR E-MAIL REQUESTS WILL BE ACCEPTED