Amount of Loan $
Purpose of Loan ie., auto, signature, real estate, etc.
Method of Repayment:
Cash/Check Payroll Deduction Auto transfer from checking/savings
Requested Term of the Loan (in months): 12 24 36 48 60 Other
Do you currently have a checking account with BHFCU? Yes No
Member Information:
Member Account Number (required)
Social Security Number:
Full Name (required) :
Residential Street Address: Own Rent

City: State: Zip:
How long have you lived at this address? Years Months
Monthly rent or Mortgage payment? $
Home Phone Number: Work Phone Number :
Date of Birth:
Marital Status (If you live in a community property State such as Texas):
Married Unmarried Separated
Previous Address (if you have lived at your current address less than 2 years):

Employment Information:
Name of Employer:
Employer's Address:
Gross Monthly Salary: $ Please fax a current p/r check stub with your loan application.
Length of Employment (Years and Months): Years Months Please include proof of income with application. can fax ck stub
Position or Job Title:
Please list any other income. You need not list income from Alimony, Child Support, or Separate Maintenance unless you wish it considered for purposes of granting this credit. Include the source and monthly dollar amount:
Email: (optional)
You authorize the credit union to obtain credit reports in connection with this application for credit and for any update, renewal or extension of credit received. If you request, the credit union will tell you the name and address of any credit bureau from which it received a credit report on you. You understand that it is a Federal crime to willfully and deliberately provide incomplete or incorrect information of loan applications.

Signature(required)x________________________________________

Please print when finished then
Fax To 713-923-4869
Thank you for your intelligent understanding. You are helping us keep the internet a safe and useful place while avoiding the pitfalls of crime on the net and against you.