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Loan Application

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First Name

Last Name

Phone

Date of Birth

Address

City

State

Zip Code

Length of time at current address

Do you rent or own?

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Monthly net income

Monthly housing payment

Income Type

Who is your current employer or source of income?

How long have you been there or received this income?

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What is your credit quality?

What loan amount do you need?

What is the loan for? Please explain.

How did you hear about us?

Are you a present or former customer to B.C. Financial, Belen Consumer Finance, or Los Lunas Consumer Finance?

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