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Contact Name
Address
City
State
Zip Code
Work Phone
Home Phone
Fax
Contact Time
Email
Loan Amount
Minimum Amount Required
Type of Loan

If Acquisition, list the price:
If Rehab, List cost of Repairs:
Type of Property
Length of Term
Desired Interest Rate %
Current Property Value
Projected / Completed Property Value:
Date of Purchase (mm/dd/yy)
Describe Collateral
Appraisal

Yes      No

Use of Funds
Borrower Cash in Project:  
Additional Cash Available for Project:
Current Liens
Lien Amount Lender

1.

1.

2.

2.

3.

3.

   
Funding Deadline:   (mm/dd/yy)
Are your Financials Available?   Yes      No
Are your Taxes Current?  

Yes      No

If "No" what is the amount owed?  

How will the Loan be Paid back?  
How is the borrowers credit ranked?
Borrower's Credit Scores (if available):
Additional Collateral Available: 
 

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