Request to lower the interest rate on the following auto loan(s). I/we authorize Star One Credit Union to order a new credit report for the purpose of this modification request. All modified loans will receive the used auto loan rate based on the member’s creditworthiness. Some restrictions may apply.

Member #   Three-digit Loan #

Primary Member's Information	Co-Applicant's Information
Name:	Name:
Address:	Address:
City, State, Zip:	City, State, Zip:
Home Phone: - -	Home Phone: - -
Work Phone: - -	Work Phone: - -
Employer:	Employer:
Gross Monthly Income: $	Gross Monthly Income: $

Prefer to reduce the payment(s) OR Prefer to keep the payment(s) the same

FEE:  $50.00 per loan
Primary member and co-applicant (if applicable) agree to pay $50.00 per loan for each modification. Please deduct the fee from
Savings, Member # OR  
Checking, Member #

All parties are required to sign before processing.

Member Signature:________________________________________ Date:_________________

Co-Applicant's Signature:___________________________________ Date:_________________

Grantor of Collateral :______________________________________ Date:_________________

Please fax completed form to: Loan Services (408) 543-5203.

---

Credit Union Use Only

Loan updated: _____________________ Updated by: ___________________________ Audited by: ___________________