Make a Request

This form is for members who are experiencing financial difficulties and would like to request a reduction in their loan repayment.

Loan Repayment Amendment

Name *

Account Number *

Contact Number *

Email Address *

Current Repayment

Amendment Required

Reduction in Amount

Change in Frequency

OtherOther

Reason for Reduction *

Current Method of Loan Repayment

Direct Debit

Standing Order

Online Transfer

Payment at Counter

I hereby apply to the Credit Union for an amendment to my loan repayment as outlined. *

Yes

I acknowledge that the Credit Union may require and request support documentation to fully consider my application. *

Yes

I understand and acknowledge that the arrangement is temporary and which, if approved, commences and ends at the dates as specified in writing by the Credit Union. *

Yes

I further understand and acknowledge that my original Credit Agreement will be amended with the revised repayments for the time period agreed and that my repayments will return to their original amount at the end of the period. *

Yes

I agree to the terms and conditions for access to and use of the Credit Union's website and webforms. I understand that the processing of my data, which may include sensitive data, is for the purposes of reviewing my request and is carried out in accordance with the Credit Union's Privacy Notice. *

Yes

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