By completing this form, you understand and agree to the Program Rules. You understand and agree that: 1) LFCU will review your account and deferrals are subject to LFCU approval; 2) there is a $10 fee per loan that you choose to skip; 3) you will resume your payments the following month; 4) the $10 fee must be available in your LFCU savings or checking account and the fee will be taken from available funds selected; 5) your loan will be extended one month beyond its maturity for each month you are approved to skip; 6) prior to your final loan payoff you will be required to make payment(s) skipped and that interest will continue to accrue at the contract rate on the unpaid balance including the month(s) chosen and have been approved to skip; 7) the fee will result in an extension of the maturity date and will increase the APR and Finance Charges disclosed on the original promissory note and the payment of this fee increases your total cost of credit. All other terms and provisions of the original loan agreement are unchanged and remain in effect; 8) you understand and agree that if you have elected GAP or Mechanical Repair Coverage, the coverage will not extend beyond the original maturity date; and, 9) other restrictions may apply.