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Full Name

Full Entity Name

Are you a Direct Borrower or a Broker

Direct Borrower

Broker

Do you want to

Purchase

Refinance

Subject Property Address

Best Email Address

Best Phone Number

Principals Involved and Percentage Ownership

Experience Level

First Deal

2-5 Deals

6-9 Deals

10 Deals and up

Property Type

Owner Occupant Non Owner Occupant

Gross Income of Property (if any) (optional)

Annual Taxes

Loan Amount Requested

Current Estimated Value of the Property?

Additional Renovation/Construction Loan Amount Requested

Terms Requested

Loan Type

Purchase Price (if purchase) (optional)

Estimated Closing Date

Amount of Cash for Down Payment and Closing Cost

Source of Down Payment

Current Cash Reserves in Bank Account

Estimated Credit Score

Was This Deal Presented to Any Other Lenders?

If So What Did You Not Like About What They Offered? (optional)

Any Foreclosures, Bankruptcies, or Outstanding Judgements? (please explain below)

Please Explain the Deal in Full Detail and the Exit Strategy Below

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