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Purchase or Refinance Requests

* Denotes Required
Prefix:    
*First Name:    
Middle Initial:    
Last Name:    
Suffix: I am:

Company Name:    
Mailing Address: Additional Address:
City: State:
Zip Code:
*Phone Number: Fax Number:
Evening Telephone: Cell Phone Number:
*Email Address:    

Type of Entity: (LLC, S-Corp, C-Corp, Sole Proprietor, Corporation, Non-Profit....)
Annual Income of Company: Credit Score (if known):
Project Name: Loan Type:
Amount of the Loan Request: Estimated Property Value:
Property Address: County:
Type of Property : Gross Rentable Square Feet :
Number of Units: Number of Vacancies:
Description of Building: Age of Building:
Purpose of the Loan: (Acquisition, Cash Out, Rate/Term Refinance, Balloon Note, Take Out)
Property Income and Expense:
Gross Scheduled Income: Other Income:
Real Estate Taxes: Property Insurance Costs:
Management Expenses: Repair and Maintenance Expense:
Reserves for Replacement: Utilities:
Other Operating Expenses:    

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