Loan Modification Request Form
I am requesting a Loan Modification on my loan with Credit Union Loan Source. I understand that this will extend the original maturity date of the loan by the length of the modified term. My interest will continue to accrue on a daily basis and will include the modification period. Any adjustment to the payment schedule of the original loan contract may cause the loan to amortize differently than originally contracted.

I understand that I am not eligible for a loan modification until I have made a minimum of twenty four consecutive payments.

I acknowledge that all outstanding fees, including but not limited to late fees and non-sufficient funds fees must be brought completely current prior to the implementation of any Due Date Change, Deferment, or Loan Modification. I understand that a failure to pay these fees will result in a delay and/or denial of my request.

Email address *
Customer Name *
Your answer
Co-Borrower Name (if applicable)
Your answer
Customer Account # *
Your answer
Reason for Modification Request *
Your answer
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