BET FEDERAL CREDIT UNION

                                                                                                                      
APPLICATION FOR LOAN
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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 ________________________________________________________________________





P.O. Box 474
                                                                                                                                                                                                            
 Bronxville, New York  10708