Express Loan Application
P. O. Box 676, Katy, TX 77492
Phone: (281) 391-2149 
To locate our fax numbers, please Click Here
Select A Branch Office:    Secure Loan Request

NOTE: Married applicants may apply for individual credit. Please check the box below if you are applying for joint credit.

Individual Credit: You must complete the Applicant section about yourself and the Other section about your spouse if:
1. you live in or the property pledged as collateral is located in a community property state (AK, AZ, CA, ID, LA, NM, NV, TX, WA, WI);
2. your spouse will use the account, or
3. you are relying on your spouse's income as a basis for repayment. If you are relying on income from alimony, child support, or separate maintenance, complete the Other section to the extent possible about the person on whose payments you are relying.

Joint Credit: Each Applicant must individually complete appropriate section below. If Co-Borrower is spouse of the applicant, mark the Co-Applicant box.

Guarantor: Complete the Other section if you are a guarantor on an account/loan.    Credit Limit Requested $
APPLICANT
 
CO-APPLICANT
Name: First, Middle, Last
Name: First, Middle, Last
Member Number:
Social Security Number:
Date of Birth:
 
Email Address:
Phone:
 
Member Number:
Social Security Number:
Date of Birth:
 
Email Address:
Phone:
Address Street: City:
 
Address Street: City:
State: Zip:
 
State: Zip:
Current Employer:
Department:
 
Current Employer:
Department:
Income: $    Per:   Income: $    Per:
Best Way to contact you:   Best Way to contact you:

Has the applicant and/or other party been the subject of an order for relief under The Federal Bankruptcy Code or adjudicated a bankrupt under the Bankruptcy Act in the last 10 years?
Are you in the military?
Are you the dependent of an active military soldier?
REFERENCES
First Name:
Middle Name:
Last Name:
Suffix:
   Home Phone Number:
   555-555-5555
   What is their home address?
Street:
City:
State:
Zip:
   What is the relationship?

TO SUBMIT ELECTRONICALLY, PROVIDE YOUR ELECTRONIC SIGNATURE BELOW,
THEN PRESS THE “SUBMIT” BUTTON

Brazos Valley Schools Credit Union will accept this electronic signature executed by you as the
legally binding equivalent of a traditional, hand written signature for this form. The electronic signature consists of your first name, last name and the last 4 digits of your social security number.

Signature:   Signature:
Date:   Date:

You agree that everything stated in this request is correct to the best of your knowledge. You understand that any false or misleading statement in your request may cause any loan or extension of credit to be in default. You authorize us to accept your electronic signatures on this request and agree that your electronic signature will have the same legal force and effect as your original signature. You assume any risk that may be associated with permitting us to accept your electronic signature. Security on one loan is security on any monies owed to the Credit Union.

I/WE SPECIFICALLY GRANT YOU A CONSENSUAL SECURITY INTEREST IN ALL INDIVIDUAL AND JOINT ACCOUNTS I/WE HAVE WITH YOU NOW AND IN THE FUTURE TO SECURE REPAYMENT OF THE CREDIT EXTENSIONS MADE UNDER THE CREDITUNION’S CREDIT AGREEMENT. THE GRANTING OF THIS SECURITY INTEREST IS A CONDITION FOR THE CREDITUNION’S CREDIT AGREEMENT. Shares and deposits in an Individual Retirement Account or any other account that would lose special tax treatment under state or federal if given as security are not subject to the security interest being given.

Your signatures indicates your request for a loan account with Brazos Valley Schools Credit Union in accordance with the terms and conditions set forth in the Credit Union’s Credit Agreement.