REFERRING BROKER CONTACT INFORMATION (IF APPLICABLE)

Broker Name

Broker Company

Phone

Email Address

BORROWER INFORMATION/GUARANTOR(1)

* First Name

M.I.

* Last Name

* Address

* City

* State

* Zip Code

* Email address

Social Security Number

Date of Birth

* Contact Phone #

Office Phone #

* Marital Status

CO-BORROWER INFORMATION/GUARANTOR(2)

Co-Borrower Information

First Name

M.I.

Last Name

Address

City

State

Zip Code

Contact Phone #

Office Phone #

Social Security Number

Date of Birth

Email address

Marital Status

BUSINESS ENTITY INFORMATION

Business Entity Information

Entity Type

Member 1

Member 3

Member 2

Member 4

LOAN DETAILS

* Type of Loan

* Property Type

* Will you be cross-collateralizing this loan with additional property you currently own?

* Borrower Strategy (Describe what you will do with the subject property)

Borrower Down Payment and/or Rehab Contributions

* Project Exit Strategy

USE OF FUNDS

* Describe Use of Funds

SUBJECT PROPERTY INFORMATION

Subject Property #1 Information

* Address

* City

* State

* Zip Code

* County

Will this property be rehabbed?

Brief Property Description and any additional information

SCHEDULE OF REAL ESTATE OWNED AND PROJECT EXPERIENCE

Prop Types: PR = primary residence; I = investment property; C = commercial property; R = raw land

Property Address (Street, City, State, Zip Code)	Property Type	Property Status	Purchase Price	Market Value	Lender	Total Mortgage & Liens








Totals

SUMMARIZE INCOME, RESERVES AND ABILITY TO SERVICE DEBT:

* Summarize Income, reserves and ability to service debt

BACKGROUND INFORMATION

* Estimated Credit Score

* Have you ever been convicted of Felony?

* Have you ever been in Foreclosure or Short Sale?

* Have you ever filed for Bankruptcy?

ACKNOWLEDGEMENT & AGREEMENT

* I/we represent and warrant that the information provided in this credit application /Real Estate Information Form is complete, accurate and true. Each individual signing below also requests and authorizes any lenders or funding source which may be utilized (collectively referred to as "Lenders") to obtain information from the references listed above and obtain commercial and /or consumer credit histories that will be ongoing and relate not only to the evaluation of the business credit requested, but also for the purposes of reviewing the account, increasing the credit line on the account (if applicable), taking collection action on the account, and for any other legitimate purpose associated with the account as may be needed.

A FACSIMILE, ELECTRONIC OR OTHER COPY OF THIS SIGNED AUTHORIZATION SHALL BE AS VALID AS THE ORIGINAL.

* Applicant's Signature (Type Initials)

* Applicant's Printed Name

* Date

Co-Applicant's Signature (Type Initials)

Co-Applicant's Printed Name

Date

Note: All questions marked with a red star (*) are required in order to complete the application. Questions that are not marked will eventually require answers to complete your loan, however you will receive a Loan Estimate if you only submit the required fields.

Loan Application