EarthMover Credit Union - Skip A Payment Form

I, ______________________________

account number ___________________________,

hereby request that Earthmover Credit Union

extend my loan number __________________________, with a balance of

$_____________________ by one month.

I will resume my payment of $__________ after skipping one payment.

To pay the $25 extension fee, I have:

Enclosed a check

Authorized a transfer from shares

It is hereby agreed that the extension of this agreement shall in no way affect the rights of the parties hereto.

___________________________________
Borrower Signature

_____________________________________
Co-Borrower Signature

Earthmover employee initials___________________

Earthmover approved date_______________________

MAIL COMPLETED FORM TO:
Earthmover Credit Union, ATTN: Skip-A-Pay Processor,
PO Box 2937, Aurora, IL 60507-2937

FAX COMPLETED FORM TO: (630) 844-3406

Some restrictions apply. Only valid for fixed rate loans. Offer ends January 31, 2008. Interest will continue to accrue during the month your payment is skipped, and the term of your loan will be extended. Loan Payment Extension Request must be submitted 10 days prior to your next loan payment due date. Only 1 loan payment per loan may be skipped during the 2007-2008 'Sno Problem skip a loan payment program.