LOAN DUE DATE CHANGE - Great Lakes Credit Union

LOAN DUE DATE CHANGE

ACCOUNT NUMBER___________________ I/WE _________________________________/________________________________ HEREBY REQUEST THAT GREAT LAKES CREDIT UNION CHANGE THE DUE DATE OF MY/OUR LOAN AS INDICATED BELOW: PRESENT DUE DATE:__________________________ ON LOAN _________L____ CHANGE TO :_________________________________. BY SIGNING BELOW YOU AGREE TO AMEND THE TERMS OF YOUR ORIGINAL AGREEMENT AND REPAY THE ENTIRE BALANCE OF $_____________________ PLUS INTEREST AT ________% BY PAYING $____________ EVERY _______________ BEGINNING ____________________. I/WE FURTHER UNDERSTAND THE NUMBER OF PAYMENTS HAVE NOT BEEN INCREASED, BUT THE INTEREST CHARGES WILL BE GREATER THAN AS STATED WHEN THE LOAN WAS GRANTED. SIGNATURE: __________________________________ DATE ________________ SIGNATURE: __________________________________ DATE ________________ VERIFICATION OF INSURANCE IS REQUIRED FOR VEHICLE LOANS. Reason for request:

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Due Date Change Request Originated ______________________________________ APPROVE / DENY __________________________ DATE________________

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