Skip A Loan Payment
                             Coupon Card

    
YES  I would like to skip the following:
                 
 (Choose & check ONLY one.)

    ______ November's Monthly Payment
    ______ December's Monthly Payment
    ______ 2 Bi-Weekly Payments before Christmas

I understand that this coupon may be used for
Auto Loans, Recreational Vehicle Loans and
Personal Loans at the cost of $45.00 per loan.

Member Name:_______________________________

Account Number:_____________________________

Loan Number(s):______________________________
____________________________________________

Daytime Phone Number:  (____ )_____________________

Is the Payment Automatically Deducted? = Yes   =No

Transfer $45.00 Fee From:
    Share Account   _____
    Share Draft Account _____
    Fee Enclosed (Check, Money Order or Cash)_____

 All requests to skip payment must be approved by the loan department.
 By signing this card you agree to amend the terms of your original
 agreement and to repay the entire unpaid balance and accrued interest.
 To be eligible for this special offer; all Credit Union accounts must be in
 good standing.  To skip your payment(s), form and fee have to be received by credit
union at least one (1)  week before payment is due.

 Borrower Signature________________________________Date____________

 Complete and return this card to Calhoun Liberty ECU or Fax to (850)674-8933
Print, fill out, sign and return the form below to the credit union at
least one (1) week before payment is due.