BET FEDERAL CREDIT UNION
P.O. Box 474
Bronxville, New York 10708
APPLICATION FOR LOAN
-Fill out completely and return to Post Office Box
Name of
Applicant______________________________________________________________________
Account#________________
Home Address (Plus
zip)__________________________________________________________________________________________
Home Phone (Plus area code)_______________________________# of Dependents
(excluding self)___________________________
Social Security #____________________________________________Date of
Birth_________________________________________
Amount of Loan or actual Cash above Balance of Present Loan $
_______________________________________________________
Purpose of Loan
_________________________________________________________________________________________________
Employer ______________________________________________________________
Phone __________________________________
Date Employed ______________________________________________ Position
____________________________________________
Annual Salary $ _____________________________ Other Annual Income $
______________________________________________
Year and Make of
Automobiles_____________________________________________________________________________________
Real Estate Owned-Location
_______________________________________________________Market
Value$___________________
OUTSTANDING DEBTS
Present
Monthly
Creditors-Address & Account #
Balance
Payment
BET Federal Credit Union
_______________________________________________________ $_______________ $
________________
Rent
__________________________________________________________________________________________
$ ________________
Mortgage:
Including
Taxes____________________________________________________________ $
_______________ $ ________________
Excluding Taxes
____________________________________________________________ $ ______________ $
________________
Auto Loan
_____________________________________________________________________ $
______________ $ ________________
Other Credit Unions
____________________________________________________________ $ ______________ $
________________
Bank
__________________________________________________________________________ $
______________ $ ________________
Bank
__________________________________________________________________________ $
______________ $ ________________
Credit Card
___________________________________________________________________ $
______________ $ ________________
Credit Card
___________________________________________________________________ $
______________ $ ________________
Other
_______________________________________________________________________ $
______________ $ ________________
Other
_________________________________________________________________________ $
______________ $ ________________
Other
_________________________________________________________________________ $
______________ $ ________________
BANK ACCOUNTS - Name of Bank, Branch & Account #
Personal Checking
_________________________________________________________________________________________________
Savings
___________________________________________________________________________________________________________
Personal Reference (not a relative)
___________________________________________________________________________________
Date ____________________________ Signature
________________________________________________________________________