After the Loan Fund has been active for 6 months, please submit this form with your credit union’s loan reporting template on a quarterly basis. Submission of this form will serve as a reimbursement request for loan loss funds. Loans must be delinquent for 90 days before a credit union can claim reimbursement.

  • Please indicate the total number of loans you are requesting to be reimbursed for due to being charged off. Loans must be in delinquency for 90 days before a credit union can claim reimbursement from the Loan Fund.
  • Please indicate the total amount of reimbursement for standard risk loans that have been charged off. If not applicable, please put '0'.
  • Please indicate the total amount of reimbursement for high-risk loans that have been charged off. If not applicable, please put '0'.
  • Please indicate the total amount of reimbursement for loans from the Portland SDL pilot group.
  • Please upload an updated loan report with each charge off identified from the original loan list.