Loan Deferment Assistance

Your Contact Information:

First Name*

Last Name*

Address*

City*

State*

Zip*

Phone Number*

Email Address*

Is there another signer on the loan? If yes, please enter the co-signer's contact information below:

Co-Signer First Name

Co-Signer Last Name

Co-Signer Address

Co-Signer City

Co-Signer State

Co-Signer Zip

Co-Signer Phone Number

Co-Signer Email Address

Please provide as much detail as possible below:

Select your loan(s)*

Auto

Visa Credit Card

Personal Loan

Personal Line of Credit

HELOC

What are the details of your hardship?*

Is your hardship temporary or permanent?*

Temporary Permanent

If temporary, how long is the hardship expected to last?

If your income has changed, what is your current source of income? (Such as unemployment, disability, etc.)

What is your current income?*

What type of assistance are you requesting from Southland Credit Union?*

What is your occupation?*

Employer Information

Employer Name*

Employer Address*

Employer City*

Employer State*

Employer Zip*

Employer Phone Number*

What was your income last month? *

If applicable, are you applying for unemployment insurance?

What is the best time to contact you?

Morning

Afternoon

Evening

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Facing financial hardship?

Southland is here to help.

Your Contact Information:

Is there another signer on the loan? If yes, please enter the co-signer's contact information below:

Please provide as much detail as possible below:

Employer Information

Southland App