Please mention the date in this format : mm/dd/yyyy.
All monetary values are to be entered in USD
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
Years in Business?
Has any Borrower had a derogatory public record in the last 5 years?
No
Yes
List Individual Borrowers OR Principals of Entity:
%Ownership:
Net Worth:
Liquid Assets:
Credit Rating:
1.
Select
Excellent
Good
Fair
Poor
2.
Select
Excellent
Good
Fair
Poor
3.
Select
Excellent
Good
Fair
Poor
4.
Select
Excellent
Good
Fair
Poor
Loan Information:
Requested Loan Amount:
Permanent
Bridge
Acquisition/Development/Consultation
Purchase
Refinance
Construction
Construction to Permanent
Other:
Purchase Price:
Earnest money deposited:
How quickly do you need to close?
Select Time-Frame
120+ days
90 days
60 days
30 days or less
Are you in a contract yet?
No
Yes
Money Available for Down payment:
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 of Project:
Is Seller Financing available?
No
Yes
Property Information: (if construction, this is the proposed information)
Select Property Type
Multi-Family
Mixed-Use
Office
Retail/Shopping Center
Self Storage
Mobile Home Park
Light Industrial
Single Tenant
Bed and Breakfast
Other
(if “other” please describe):
Property Address:
City:
Select State
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
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):
Select Condition
Excellent
Good
Fair
Poor
Current % Occupancy:
CURRENT Annual gross income of property:
Current:
CURRENT Annual expenses of property:
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:
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