CUSTOMER INFORMATION

LOAN DUE DATE CHANGE

PO Box 4597 | Oak Brook, IL 60523-4597 | (866) 455-7623

In order to change the due date on your loan account with FreedomRoad Financial, please complete this form in its entirety and then read & understand our agreement before signing the form. ALL DUE DATE CHANGES ARE SUBJECT TO FREEDOMROAD FINANCIAL'S APPROVAL. CERTAIN RESTRICTIONS MAY APPLY.

Customer Name: Account Number:

CUSTOMER INFORMATION

Current Due Date:

Today's Date: New Due Date:

? I request the payment due date for the loan number listed above to be changed.

? I understand that I am still responsible for making all the remaining payments as scheduled and that the original loan maturity date will not change; therefore the final installment may be higher or lower than originally scheduled.

? I understand that FreedomRoad Financial may require a 5 day processing time for this change to be effective.

? I understand that the due date may be moved up to 10 days forward and may only be changed twice during the life of the loan.

Signature:

AUTHORIZATION

Date:

Please fax completed form to 630-684-0278; or mail to:

FreedomRoad Financial Attn: Loan Operations

PO Box 4597 Oak Brook, IL 60523-4597

Input By: Verified By:

Internal Use Only

Date: Date:

FreedomRoad Financial is a division of Evergreen Bank Group, an Illinois chartered banking institution.

MEMBER FDIC

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download