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Loan pre-qualification form
Loan Type:
HVAC
Programmable Thermostat
Window Tinting
Insulation
Windows
Awnings
Appliance
Solar Shades
BTU Account Number:
Name (First, Middle, Last):
Phone Number:
E-mail Address:
Social Security #:
Driver's license:
Address of Installation:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
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New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Nearest Relative:
Present Employer's Name
Employer's Phone Number:
Minimum Loan Amount is $500 to a Maximum Loan Amount of $10,000.
Items may be combined in one loan.
My acceptance below certifies that the information provided is true and correct. I understand that I am not entering into a loan agreement with BTU by accepting below, but am authorizing BTU to run a credit check to determine my credit worthiness for the loan program. I also certify that I own the above residence and this loan, if approved, will be used for (HVAC, Insulation, Appliance or Surge Protection) installation at this property.
I have read and accept the terms of this agreement.
All residential customer requesting surge protection through summation of this form are approved.
For Internal use only.
First Name:
Last Name:
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