Loan Application


	Baptist Employees of Louisiana
	To contact us: Call Toll Free (800) 622-6549 or (318) 448-3402 BEL Federal Credit Union P.O. Box 7667 Alexandria, LA 71306 E-Mail: belfcu@centurytel.net

Loan Liner Credit Application

1. Note and Complete
Married Applicants may apply for a separate account. Check the appropriate box to indicate Individual Credit or Joint Credit. Use tab key to navigate through form.
	Individual Credit: Complete Applicant section. Complete Co-Applicant, Spouse, Guarantor (referred to as "Other") section: (To check box, use one mouse click)
	(1) about your spouse if you live in a community property state (AZ,CA,ID,LA,NM,NV,TX,WA,WI) or
	(2) if your spouse will use the Account, or
	(3) if there is a guarantor on this account.
	Please check box to indicate whom the information is about.
	Joint Credit: Provide information about both of you by completing Applicant & Other section.
Amount Requested
Purpose:
Collateral:
Repayment: Payroll Deduction Cash Automatic Payment Military Allotment Other
Statement of Intent - Check if Desired

Credit Disability Insurance		Check coverage(s) desired. The credit union will disclose the cost of this voluntary insurance to you. A separate insurance election which discloses the terms and conditions must be signed for coverage to become effective.
Single Credit Life Insurance
Joint Credit Life Insurance


Please Note:
*First, all Applicant information is completed on left side of screen, then all Co-Applicant, Spouse or Guarantor information is completed on right side of screen.

2. Applicant Information

"Applicant" Section			"Other" Section Co-Applicant Spouse Guarantor Use "SAA" if information is "Same As Applicant".
Name (Last-First-Middle Initial)			Name (Last-First-Middle Initial)

Driver's License Number/State			Driver's License Number/State

Account Number	Social Security Number		Account Number	Social Security No.

Birthdate	Home Phone (Area Code)		Birthdate	Home Phone(Area Code)

Business Phone/Extension			Business Phone/Extension

Present Address (Street-City-State-Zip)			Present Address (Street-City-State-Zip)

Years at this address	Own Rent		Years at this address	Own Rent

Previous Address (Street-City-State-Zip)			Previous Address (Street-City-State-Zip)

Years at this address	Own Rent		Years at this address	Own Rent

Complete for Joint Credit, Secured Credit or if you live in a community Property State:			Complete for Joint Credit, Secured Credit or if you live in a community Property State:
Married Separated Unmarried (Single-Divorced-Widowed)			Married Separated Unmarried (Single-Divorced-Widowed)

List Ages of Dependents not listed by other Applicant: (Exclude Self)			List Ages of Dependents not listed by other Applicant: (Exclude Self)


3. Employment Information
Applicant			Co-Applicant/Spouse/Guarantor

Name and Address of Employer			Name and Address of Employer

Your Title/Grade			Your Title/Grade

Supervisor's Name			Supervisor's Name

Start Date	Hours at Work		Start Date	Hours at Work

If Self Employed, Type of Business			If Self Employed, Type of Business

If Employed in Current Position LESS than FIVE YEARS, complete previous Employer Name and Address			If Employed in Current Position LESS than FIVE YEARS, complete previous Employer Name and Address

Starting Date	Ending Date		Starting Date	Ending Date

Military: Is Duty Station Transfer expected during next year Yes No			Military: Is Duty Station Transfer expected during next year Yes No
Where			Where

Ending/Separation Date			Ending/Separation Date

4. References
Please include Street, City, State and Zip
Name, Address, and Telephone Number of Creditor(s) of Debts Paid Off			Name, Address, and Telephone Number of Creditor(s) of Debts Paid Off

Name, Address, and Telephone Number of Nearest Relative NOT Living with You			Name, Address, and Telephone Number of Nearest Relative NOT Living with You

Relationship of this Relative			Relationship of this Relative

Name, Address and Telephone Number of Personal Friend - Not a Relative			Name, Address and Telephone Number of Personal Friend - Not a Relative


5. Income Information
Notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered.

Employment Income			Employment Income
Amount	Hrly,Wkly,Mthly, or Yearly		Amount	Hrly,Wkly,Mthly,Yearly
per			per
Net Gross			Net Gross

Other Income			Other Income
Amount	Hrly,Wkly,Mthly, or Yearly		Amount	Hrly,Wkly,Mthly,Yearly
per			per
Source			Source

6. Assets
List all assets and account number(s) -- Note in the comment box if you are mailing an additional sheet into the BEL office.

Share Draft or Checking Amount			Share Draft or Checking Amount

Name and Address of Depository			Name and Address of Depository


Savings Amount			Savings Amount
Name and Address of Depository			Name and Address of Depository


List Home and All Other Items You Own and Location of Property (For Example: Auto, Boat, Stocks, Bonds, Cash, Household Goods, Real Estate, etc.) -- Note in the comment box if you are mailing an additional sheet into the BEL office.

Item #1			Item #1

Market Value of Item			Market Value of Item
Pledged as Collateral for Another Loan Yes No			Pledged as Collateral for Another Loan Yes No

Item #2			Item #2

Market Value of Item			Market Value of Item
Pledged as Collateral for Another Loan Yes No			Pledged as Collateral for Another Loan Yes No

Item #3			Item #3

Market Value of Item			Market Value of Item
Pledged as Collateral for Another Loan Yes No			Pledged as Collateral for Another Loan Yes No

Item #4			Item #4

Market Value of Item			Market Value of Item
Pledged as Collateral for Another Loan Yes No			Pledged as Collateral for Another Loan Yes No

Item #5			Item #5

Market Value of Item			Market Value of Item
Pledged as Collateral for Another Loan Yes No			Pledged as Collateral for Another Loan Yes No

Additional Comments:			Additional Comments:


7. Debts
In addition to Rent/Mortgage, list all other debts (for example, auto loans, credit cards, second mortgage, home assoc. dues, alimony, child support, child care, medical, utilities, auto insurance, IRS liabilities, etc.) Please use a separate line for each credit card and auto loan. -- Note in the comment box if you are mailing an additional sheet into the BEL office.

Creditor #1			Creditor #1
Rent Mortgage			Rent Mortgage
Creditor Name and Address			Creditor Name and Address

Account Number			Account Number
Original Balance			Original Balance
Present Balance			Present Balance
Monthly Payment			Monthly Payment
Check if this Account is Past Due			Check if this Account is Past Due

Creditor #2			Creditor #2
Creditor Name and Address			Creditor Name and Address

Account Number			Account Number
Original Balance			Original Balance
Present Balance			Present Balance
Monthly Payment			Monthly Payment
Check if this Account is Past Due			Check if this Account is Past Due

Creditor #3			Creditor #3
Creditor Name and Address			Creditor Name and Address

Account Number			Account Number
Original Balance			Original Balance
Present Balance			Present Balance
Monthly Payment			Monthly Payment
Check if this Account is Past Due			Check if this Account is Past Due

Creditor #4			Creditor #4
Creditor Name and Address			Creditor Name and Address

Account Number			Account Number
Original Balance			Original Balance
Present Balance			Present Balance
Monthly Payment			Monthly Payment
Check if this Account is Past Due			Check if this Account is Past Due

Creditor #5			Creditor #5
Creditor Name and Address			Creditor Name and Address

Account Number			Account Number
Original Balance			Original Balance
Present Balance			Present Balance
Monthly Payment			Monthly Payment
Check if this Account is Past Due			Check if this Account is Past Due

Creditor #6			Creditor #6
Creditor Name and Address			Creditor Name and Address

Account Number			Account Number
Original Balance			Original Balance
Present Balance			Present Balance
Monthly Payment			Monthly Payment
Check if this Account is Past Due			Check if this Account is Past Due

Creditor #7			Creditor #7
Creditor Name and Address