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I am
the borrower
a broker
other third party
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Borrower's
Name:
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Relationship
to Borrower:
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Company:
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City:
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State:
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Zip:
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Business
Phone Number:
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Alternate
Phone Number:
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Fax:
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E-mail:
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Borrower's
approximate mid credit rating:
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Borrower's
approximate income (per year):
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Borrower's
approximate net worth:
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$
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Will
there be a co-borrower?
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Yes
No
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Co-Borrower's
Name:
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Co-Borrower's
approximate mid credit rating:
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Co-Borrower's
approximate income (per year):
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Co-Borrower's
approximate net worth:
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$
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PROPERTY DETAILS
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Subject
Property Street Address:
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City:
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State:
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AS-IS
market value of the property:
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$
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Indications
of this value:
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Comps
Appraisal
Other
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Describe
other indicators of current value:
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Subject
Property Type:
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Total
Square Footage:
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sq. ft.
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No.
of Bedrooms:
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No.
of Bathrooms:
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Size
of Lot/Parcel:
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acres
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Is
the subject property (or will the subject
property be) the borrower's primary
residence?
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Yes
No
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Will
the subject property be partially or wholly
occupied by the borrower?
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Yes
No
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Total
Acreage:
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acres
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Please
add any further description of the
property:
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LOAN DETAILS
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Requested
loan amount:
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$
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Requested
term of loan:
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months
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Type
of Loan:
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Purchase
Refinance
Construction/Rehab
with acquisition
Construction/Rehab
with refinance
Subordinate
Loan
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Purchase
Price:
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$
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Will
the seller carry back a second?
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Yes
No
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Amount
of carry-back:
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$
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Will
the borrower make a down payment?:
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Yes
No
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Amount
of down payment:
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$
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Projected
market value of the property:
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$
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Indications
of this value:
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Comps
Appraisal
Other
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Describe
other indicators of projected value:
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Estimated
cost of the above construction/
improvements:
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$
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Total
amount currently owed:
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$
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Total
amount of debt on property that will remain
senior to our loan:
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$
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Plan
for repayment:
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Sale
Refinance
Other
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Describe
other plan for repayment:
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Required
Closing Date:
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Comments:
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How
did you hear about us?
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