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Please supply as much information as you can. Doing so will help us to expedite your loan request.

Borrower Information
Borrowing Entity: Individual Partnership Corporation
Mailing Address: City: Zip:
Telephone: Cell: Fax: Email:
Has any Borrower had a foreclosure or bankruptcy in the last 5 years? No Yes
Has any Borrower had a derogatory public record in the last 5 years? No Yes
Years in business?

List Individual Borrowers OR Principals of Entity: % Ownership: Net Worth: Liquid Assets: Credit Rating:
1.
2.
3.
4.

Loan Information
Requested Loan Amount:
Purchase Refinance Construction
Permanent Bridge Acquisition/Development/Construction
Construction to Permanent Other:
Purchase Price: Earnest Money Deposited:
How quickly do you need to close? Are you in contract yet? No Yes
Money Available for Downpayment: Is Seller Financing available? No Yes
Original Purchase Price: Original Purchase Date:
Last Appraised Value: Last Appraisal Date:
Current Balance Outstanding: Maturity Date:
Name of current lien-holder: Monthly Payment:
Prepayment penalty on current loan? No Yes Pre-payment Amount:
Amount of original down-payment: Current interest rate:
Cost of improvements already made: Cost of proposed improvements:
Description of improvements made:
If Cash-Out Refi, Proposed use of proceeds:
Purchase Price of Land: Date of Land Purchase:
Last Appraised Value of Land: Last Appraisal Date of Land:
Last Appraised Value of Project: Last Appraisal Date of Project:
Existing lien on Land: Project will be built by:
Total cost of Construction: Number of units pre-sold:
Is Infrastructure completed? No Yes Has project been master-planned? No Yes
Money Available for Project: Is Seller Financing available? No Yes

Property Information (if Construction, this is the proposed information)
(If "other" please describe):
Property Address: City: Zip:
Percentage of property to be owner-occupied: If owner-occupied, what is nature of the business?

# of Buildings: Building Sq Ft: # of Units: Acres:
# of Tenants: Building Ages: # of Stories:
Physical condition of building(s):
CURRENT Annual gross income of property:
CURRENT Annual expenses of property:
  Current % occupancy:
Current:
Last Year:
2 Years Ago:

Permission to Contact Given By
Person completing this form: Daytime Number: Email:
How did you hear about this site OR who referred you:
Additional Comments: