Apply Online For a Property Tax Loan Fill out this form to apply for a BCPTL property tax loan Please fill out this form and we will get back to you as soon as possible. Fields marked with * must be completed. Borrower InformationName* First Last Title Phone Number* Secondary phone Email* Date of Birth* MM slash DD slash YYYY Last four digits of SSN or Taxpayer ID*Marital Status* Occupation Length of Employment in Current Job Gross Monthly Income* Total Monthly Expenses* Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Would you like to speak to someone in Spanish? Yes Have you contacted us before?* Yes No Not sure Who did you speak with?Ken BlaschkeRick FarleyJimmie GarciaDavid GreenRich JohansenMichelle MonroeJavier PuenteNot sureHow did you hear about us? (select several if applicable)* Mailing Internet search Referral (friend, family, County, etc.) Other What piece of mail did you receive?* A code with letters and numbers can be found at the top of your mailing - right above your mailing address and name. It should look something like these examples: BCL1, BCFL7, BCPC3. If you can't find the code please enter in the phone number provided in the mailing.Spouse or Co-Borrower InformationName First Last Title Home Phone Cell Phone Email Date of Birth MM slash DD slash YYYY Last four digits of SSN or Taxpayer IDMarital Status Occupation Length of Employment in Current Job Gross Monthly Income Total Monthly Expenses Mailing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Property InformationProperty Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County* Estimated Property Value* Estimated Taxes Due* Is the property your homestead?* Yes No Is there a mortgage on the property?* Yes No Is there a lawsuit on the property?* Yes No Has the property been noticed for Foreclosure?* Yes No Foreclosure date:* Currently in bankruptcy?* Yes No Is the property a mobile home?* Yes No Is Borrower or Co-Borrower disabled?* Yes No Do you have more properties?* Yes No Hiddenutm_source Hiddenutm_medium Hiddenutm_campaign Hiddenutm_content Hiddenutm_term Hiddenkeyword Hiddennetwork Hiddenadgroupid HiddenReferral Source Telco Consent By submitting this form you consent to us calling you back using an automated dialing system and to receive text messages to the above provided phone number. Message & data rates may apply.
