Loan Inquiry Form

Loan Officer/Mortgage Broker

Is there a Broker involved?

Yes No

Email Address

First Name

Last Name

Company Name

Phone Number

Are you a Loan Officer or working with one?

Yes No

Email Address

First Name

Last Name

Company Name

Phone Number

Type of Loan?

SBA Loan product

Additional Desired Loan programs

Where are you in the process?

Lead Source

Guarantor #2 Information

Borrower Type/Entity Info

Borrower Type

Corporate Secretary Name

Sales Method

Retail Swiped

%

KEYED

%

ECOMM

%

MOTO

%

Fee Schedule

Visa/MasterCard/Discover/AXP Qualified Credit Card Discount Rate(for Tiered/Flat) %

%

Visa/MasterCard/Discover/AXP Qualified Credit Card Pass Thru I/C Plus

Qualified Check Card Discount Rate (for Tiered/Flat)

%

Qualified Check Card PassThru I/C Plus

Visa/MasterCard/Discover/AXP

$

Authorization Fee

$

Monthly Program Fee "Cash Discount"

$

Customer Service Fee

$

Monthly Minimum Fee

$

PIN Debit Transaction Fee

$

Batch Fee

$

Amex OPT Blue Qualified Rate

%

Amex OPT Blue Mid Qual

%

Amex OPT Blue Non Qual

%

Amex OPT Blue Pass Thru I/C Plus

Amex ESA #

AVS Transaction Fee

$

EBT Transaction Fee

$

EBT Account#

Amex Processing Fee

%

Other Fee

$

3 Tier Pricing Visa/MC/Disc/AXP Mid Qual

%

3 Tier Pricing Visa/MC/Disc/AXP Non Qual

%

Chargeback Fee

$

ACH Retrieval Fee

$

Equipment Info

Are you currently using a point of sale system?

Yes No

Software

Software Version

Additional Guarantors

Are there any additional guarantors?

Yes No

First Name

Middle Name

Last Name

Guarantor Type

Workj Phone

Mobile Phone

Social Security #

Date Of Employment

Marital Status?

Guarantor Address

City

State

Zip

Email Address

Credit Score

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Guarantor Notes

General Guarantor Notes

Demographic Information for Individual

Demographic Information for Co-Applicant

Guarantor #1 Background

Are you a U.S. Citizen?

Yes No

Origin

Visa Status

Guarantor #2 Background

Are you a U.S. Citizen?

Yes No

Origin

Visa Status

Borrower Experience

Does borrower have Fix & Flip or Buy & Hold experience?

Yes No

# of years of experience?

# of properties completed in last 36 months

List 3 examples of past deals - Fix & Flip / Buy & Hold

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Address

City

State

Zip

Unit/Suite #

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Address

City

State

Zip

Unit/Suite #

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Address

City

State

Zip

Unit/Suite #

Does borrower have ground up construction experience?

Yes No

# of years experience?

# of properties completed in last 36 months

List 3 examples of past deals - Ground Up

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Sale Date

Address

City

State

Zip

Unit/Suite #

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Sale Date

Address

City

State

Zip

Unit/Suite #

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Sale Date

Address

City

State

Zip

Unit/Suite #

Are you a builder/developer?

Yes No

Do you have a GC on staff, or do you hire a third-party GC to complete rehab/construction?

Yes No

Does borrower have experience selling properties without construction (e.g., wholesaling)?

Yes No

# of years experience?

# of properties completed in last 36 months

List 3 examples of past deals - Selling

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Sale Date

Address

City

State

Zip

Unit/Suite #

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Sale Date

Address

City

State

Zip

Unit/Suite #

Property Type

Purchase Date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Sale Date

Address

City

State

Zip

Unit/Suite #

Does borrower have any projects currently in progress?

Yes No

How many?

Does borrower own investment properties?

Yes No

How many?

Is borrower a member of an investment club or group?

Yes No

Name of Group/Club?

Do you have any professional licenses?

Yes No

Select Professional license

License #

Are you a full time real estate investor?

Yes No

How much liquid assets does borrower currently have?

Primary investment strategy

Describe Your Overall Real Estate Investment Experience

Primary investment strategy Explain

Track Record

Typical Transactions

Amount of financing requested

$

To

$

Typical purchase price

$

To

$

Typical construction costs

$

To

$

Typical sale price

$

To

$

No. of construction draws per project

To

Months from purchase date to first construction draw

To

Months from purchase date until construction complete

To

Months from purchase date to sale date

To

No. of such projects that you will do at time

To

In which geographic areas do you intend to focus on the next 12-24 months?

Co-borrower Experience

Financial Questions

$

Purpose of the loan:

Payroll Rent/Mortgage Interest Utilities Other

Are there any obligations not listed on the financial statements for which you or your business is an endorser, guarantor, or co-maker? If yes, what is the total liability?

Yes No

Total Liability

Is your business a party to any claim or lawsuit?

Yes No

Detailed Explanation

Have you or any of the principals or this business ever owned or operated a business which declared bankruptcy?

Yes No

Detailed Explanation

Does your business owe taxes for years prior to the current year?

Yes No

Detailed Explanation

Is the Applicant a franchise that is listed in the SBAs Franchise Directory?

Yes No

Detailed Explanation

Does the Small Business Applicant have any Affiliates?

Yes No

Detailed Explanation

Has the Small Business Applicant and/or its Affiliates ever filed for bankruptcy protection?

Yes No

Detailed Explanation

Is the Small Business Applicant and/or its Affiliates presently involved in any pending legal action?

Yes No

Detailed Explanation

Is the Applicant or any owner of the Applicant presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any bankruptcy?

Yes No

Detailed Explanation

If you are at least a 50% or more owner of the applicant business, are you more than 60 days delinquent on any obligation to pay child support arising under an administrative order, court order, repayment agreement between the holder and a custodial parent, or repayment agreement between the holder and a state agency providing child support enforcement services? .

Yes No

Detailed Explanation

Has the Small Business Applicant and/or its Affiliates ever obtained a direct or guaranteed loan from SBA or any other Federal agency or been a guarantor on such a loan?

Yes No

Is any of the financing currently delinquent?

Yes No

Detailed Explanation

Did any of this financing ever default and cause a loss to the Government?

Yes No

Detailed Explanation

Are any of the Small Business Applicants products and/or services exported or is there a plan to begin exporting as a result of this loan?

Yes No

Provide the estimated total export sales this loan will support:

$

Is the Small Business Applicant using (or intending to use) a packager, broker, accountant, lawyer, etc. to assist in (a) preparing the loan application or any related materials and/or (b) referring the loan to the lender?

Yes No

Detailed Explanation

Are any of the Small Business Applicants revenues derived from gambling, loan packaging, or from the sale of products or services, or the presentation of any depiction, displays or live performances, of a prurient sexual nature?

Yes No

Detailed Explanation

No SBA employee, or the household member (see definition on page 1) of an SBA employee, is a sole proprietor, partner officer, director, or stockholder with a 10 percent or more interest, of the Applicant.

Yes No

Detailed Explanation

No former SBA employee, who has been separated from SBA for less than one year prior to the request for financial assistance, is an employee, owner, partner, attorney, agent, owner of stock, officer, director, creditor or debtor of the Applicant.

Yes No

Detailed Explanation

No member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government, is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or household member of such individual, of the Applicant.

Yes No

Detailed Explanation

No Government employee having a grade of at least GS-13 or higher is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or a household member of such individual, of the Applicant

Yes No

Detailed Explanation

No member or employee of a Small Business Advisory Council or a SCORE volunteer is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or a household member of such individual, of the Applicant.

Yes No

Detailed Explanation

Have you, or any business you controlled, ever filed for bankruptcy protection?

Yes No

Detailed Explanation

Is the United States the principal place of residence for all employees of the Applicant included in the Applicants payroll calculation above?

Yes No

Detailed Explanation

Do any of your employees earn more than $100,000/year?

Yes No

If Yes, Did you calculate your estimated monthly payroll using the cap of 100,000 per employee?
Detailed Explanation

Has the Applicant, any owner of the Applicant, or any business owned or controlled by any of them, ever obtained a direct or guaranteed loan from SBA or any other Federal agency that is currently delinquent or has defaulted in the last 7 years and caused a loss to the government?

Yes No

Detailed Explanation

Are you, or any business you control, presently involved in any legal action (including divorce)?

Yes No

Detailed Explanation

Has the Business received an SBA Economic Injury Disaster Loan between January 31, 2020 and April 3, 2020?

Yes No

Loan Amount

$

Detailed Explanation

Yes No

Detailed Explanation

Other Business/Affiliate Information

Company Name

Tax Id/EIN #

Legal Owners/Title/Ownership %

# of employees

Years in Business

Has applied for SBA loans?

Yes No

Description

Assets (Include Borrower + Co-borrower amounts if any)

Type

Estimated Value ($)

Amount Owed ($)

Cash in this Bank (including money market accounts, CD's)

$

Cash in Other Financial Institutions (including money market accounts, CD's)

$

Readily Marketable Securities (Schedule A)

$

Non-Readily Marketable Securities (Schedule A)

$

Accounts & Notes Receivable

$

Residential Real Estate

$

Partnership / PC Interests

$

Deferred Income

$

IRA / Keogh / Profit Sharing and Other Vested Retirement Accounts

$

Other

$

Total cash in bank accounts

$

Total value of retirement accounts

$

Availability under lines of credit

$

Home

$

Secondary Residences

$

Other Real Estate

$

Cars

$

Other Personal Property

$

Other Assets

$

Notes Payable to Banks & Others

$

Installment Account(s)

$

Revolving Debt

$

Unpaid/Payable Taxes

$

Secured Notes Payable to this Bank

$

Unsecured Notes Payable to this Bank

$

Accounts Payable (including credit cards)

$

Margin Accounts

$

Other Liabilities Owed

$

Other Assets Details

Other Liability Details

Unpaid Taxes Details

Total:

$

Total Est. Value

- Total Amt Owed

= Total Net Worth

$

- $

= $

Gifts or Grants

Gifts Or Grants : 1

Asset Type

Deposited/Not Deposited

Yes No NA

Source

Cash Or Market Value

$

Add Gifts Or Grants Info

Contingent Liabilities

Contingent Liabilities 1

Type Of Liability

Name of Company/Creditor

Monthly Payment

$

Months left to Pay

Balance/Amount

$

Account No

Description

Add New Contingent Liabilities

Guarantor #1 Employment Information

Position

Employment Type

Date of Employment

Nature of Employers Business

I have ownership share of less than 25% I have ownership share of 25% or more

Monthly Income/Loss $

$

How often are you paid?

Weekly Monthly Every 2 weeks Twice a month

Employer Information

Guarantor's Employer

No. Of Years with Employer

Employer Address

Employer City

Employer State

Employer Zip

Employer Country

Name of previous employer & position (if with current employer less than 3 years)

Employer Phone

May we contact you at work?

No. of Yrs.

Additional Employment Information : 1

Is this job an additional or previous Job?

Name

Address of Employer

Employer City

Employer State

Employer Zip

Employer Country

Employment Type

Employed From

Employed To

Yrs employed in this line of work / profession

Employed by a family member, property seller, real estate agent, or other party to the transaction?

Are you the business Owner or Self-Employed?

Monthly Income

Overtime

Commission/Bonus

Military Entitlements

Other

Income from other sources

Total Monthly Income from Other Sources

Position / Title / Type of Business

Employer Phone

Guarantor #2 Employment Information

Borrower Monthly Income

Salary

$

Commission/Bonus

$

Partnership Income

$

Interest Income

$

Rental Income

$

Dividend Income

$

Capital Gains

$

Other Investment Income

$

Other Income

$

Other Income Description

Total Income

$ 0.00

(Borrower)

Co-borrower Monthly Income

Salary

$

Commission/Bonus

$

Interest Income

$

Rental Income

$

Dividend Income

$

Capital Gains

$

Partnership Income

$

Other Investment Income

$

Other Income Description

$ 0.00

(Co-Borrower)

$ 0.00

(Borr + Cobor)

Borrower Monthly Expenses

Monthly Payment

Bal Owed

This loan

$

Property Taxes

$

Rental Payments, Co-op or Condo Maintance

$

Mortgage Payments

$

Interest & Principal Payments on Loans

$

Insurance

$

Investments (including tax shelters)

$

Alimony/Child Support

$

Federal Income and Other Taxes

$

State Income and Other Taxes

$

Rental Payments, Co-op or Condo Maitenance

$

Mortgage Payments - Residential

$

Mortgage Payments - Investment

$

Property Taxes - Residential

$

Property Taxes - Investment

$

Interest & Principal Payments on Loans

$

Insurance

$

Investments (including tax shelters)

$

Tuition

$

Other Living Expenses

$

Medical Expenses

$

Other Expenses

$

Total Expenses

$

(Borrower)

Co-borrower Monthly Expenses

Monthly Payment

Bal Owed

Existing mortgages and Taxes/Insurance

$

Installment Loans

$

Credit Cards

$

Student Loans

$

Alimony/Child Support

$

Other

$

Total Household Expenses

$

(Co-Borrower)

$

(Borr + Cobor)

Liabilities

Alimony Payments

$

Child Support Payments

$

Separate Maintenance Payments

$

Job Related Expense (Child Care, union Dues, Etc).

$

Other Payments

$

Owed To

Partnerships

Partnerships 1

Type of Investment

Date of Initial Investment

Cost

$

Percent Owned

%

Current Market Value

$

Balance Due on Partnership: Holds, Cash, Call

$

Final Contribution Date

Add New Partnerships

Current Mortgage(s) On Subject Property

Other New Mortgage Loans : 1

Mortgage Lien Balance

Lien Type

Monthly Payment

$

Rate

$

Original Balance

$

Add Other New Mortgage Loans

Loan Settings

Desired loan amount

$

Desired Interest Rate Range

%

Term

Transaction Type

Use Of Funds

Amortization Type

Fixed Rate Adjustable Rate

%

Monthly Escrows for Taxes & Insurance

Yes No

Annual Property Tax

$

Annual Insurance Policy Premium

$

Current Loan Balance

Total Loan Amount

Accrual Type

$

Acquisition / Purchase Price

$

%

Important Dates

Desired Closing Date

Funding Date

Maturity Date

Building Analysis Due Date

Rehab Construction Info

Will the property need a holdback?

Yes No

Is the subject property(ies) currently under construction?

Yes No

How many additional square feet are you adding?

Improvements to be Completed

Renovation Timeframe (months)

Plans and Permits Status

Does project require re-zoning?

What is your anticipated hold time (months)?

Months

What is your anticipated plans and permit timeline (months)?

Months

What is your anticipated construction timeline (months)?

Months

Building Analysis Outstanding

Building Analysis Need

Construction Type

Construction Hard Cost

$

Construction Soft Cost

$

Contingency Type

Contingency %

%

Contingency Amount

$

Loan Request

Acquisition Down Payment

$

Down Payment %

Initial Loan Amount

$

Closing Costs Financed

$

%

Fees & Costs

Origination Points @

Points

Include Closing Cost Financed

$

Lock Origination Fee

Closing Cost Financing Fee

$

Application Fee

$

Estimated Title Insurance Fees

$

Draws Set Up Fee

$

Valuation - BPO

$

Credit Report

$

Flood Certificate

$

Wire Fee

$

Tax Service

$

Inspection Fees

$

Good Faith Deposit

$

Lender Credit to Offset 3 rd Party Fees

$

Settlement or Closing/Escrow Fee

$

Underwriting Fees

$

Discount Fee

$

Pre paid Interest

$

Insurance Premium

$

Wire Transfer Fee to Title

$

Past Due Property Taxes

$

Wholesale Admin Fee

$

Valuation - AVE

$

Employment Verification Fee

$

Tax Return Order Fee

$

Months

$

Broker Points @

Points

Include Closing Cost Financed

$

Lock Broker Fee

Attorney Fee

$

Appraisal Fee

$

Processing Fees

$

Draws Fee

$

Valuation - AVM

$

Background Check

$

Document Preparation

$

Servicing Set Up Fee

$

Flood Service

$

Project Feasibility

$

Ucc/Lien Search

$

Recording Fee

$

Property tax

$

Travel Notary Fee

$

Real Estate Taxes

$

Pay Off Liens/Creditors

$

Wire Transfer Fee to Escrow

$

Survey

$

Broker Processing Fee

$

Valuation - CMA

$

Credit Check Fee

$

City/County Tax Stamps

$

Construction Holdback Fee

$

Seller Credits Fee

$

Months

$

Per Diem Accrual Type

Interest Charged From

Interest Charged End (Inclusive)

: x Per Diem Interest: $ (@ 0 %) = Accrued Per Diem Interest: $

Total Fees & Costs

$

Percentage of Closing Cost Financed

%

Net Lender Funds to Title

$ 0.00

Total Loan Amount

$

Lender notes on closing costs and any additional fees.

Include notes on term sheet?

Additional Loan Settings

Existing Mortgage Debt

Existing Mortgage Debt 1

Lien Number

Pay-Off Amount

$

VOM Status

Payoff Status

Original Purchase Date

Mortgagee / Lender

Current Lender Full Address

Current Lender Email

Original Purchase Price

$

Maturity Original / Date

Pre-Payment Penalty Amount

$

Pre-Payment Penalty %

%

Cost of improvements made

$

Are taxes and insurance included in the payment?

Yes No

Monthly Payment

$

Current Rate

%

Current Loan Balance

$

Good Through Date

Original Loan Balance

$

Add New Mortgage

Real Estate Collateral

1) Subject Property Details

Is this the main subject property?

Property Location

Subject Address

Subject Unit#

Subject City

Subject State

Subject Zip Code

Subject Country

Subject Property County

Location

Urban Rural Suburban

Municipality

Parcel No

Legal Description

District

Section

Block #

Lot #

MSA

Property Analysis

Allocated Loan Amount

$

Annual Hazard Insurance

$

Annual Flood Insurance

$

Total Hazard + Flood Insurance

$

Annual Property Tax

$

Property Tax Source

Annual HOA Fees

$

Annual Total Expenses

$

Total Existing Lien Payoffs

$

Gross Operating Income

$

Net Operating Income

$

30-Year Amortization Payment

$

Interest-only Payment

$

PITIA

$

ITIA

$

Value Used For Metrics(Purchase or AIV)

Required Valuation Methods

Allocated LTP (Loan-To-Purchase)

%

Allocated LTV

%

Qualifying Allocated LTV

%

30-Yr AM DSCR

%

Property Details

Estimated Property Value

$

After Repair Value

$

Purchase Price

$

Property LTV

%

Loan-To-After-Repair Value (LTARV)

%

Zillow value

$

Get Zillow Value

Price Per Door

$

URL link 1 to Property

URL link 2 to Property

Subject Present Occupancy

Occupancy Notes

Subject Property Condition

Condition Notes

Year Renovated?

Tax year

Annual Property Taxes

$

Itemized Property Taxes

Annual Property Tax

$

Calculate from itemized taxes

This section is disabled. Itemized rows are preserved but not editable. Check "Calculate from itemized taxes" above to enable editing and use the sum as the Annual Property Tax.

	Type	Label	Amount	Status	Due Date	Actions
No itemized taxes yet. Click + Add Itemized Tax to add one.
Total of Itemized Taxes:				Paid rows are excluded from the total.

Property Tax Due Date

Annual Real Estate Taxes

$

Lien Release/Payoff Amt

$

MLS Number

Annual Insurance Premiums

$

How long will it take for rehab to complete?

In Months

Property Access

Who to contact for property access? Name

Email

Lock Box Info

Phone:

Can we obtain interior access?

Yes No

Relationship

Rent Roll

Rent Roll 1

Tenant

Unit Type

Unit #

Size

Bedroom

Bath

Half Baths

Lease Start Date

Lease Expiration Date

Date of Last Rent Increase

Lease Payment Frequency

Lease Extension End Date

Move in Date

Preliminary Estimated Rents

$

Preliminary Rent Source

Market Rents

$

120% Market Rents

$

Market Rent Source

Actual Rents

$

Lease Validation

Monthly Rent

$

Subsidized

Yes No

Vacant

Yes No

Section 8

Yes No

Comments

Upload Lease

Add New Rent Roll Entry

Property Flood Certificates

Property Flood Certificates 1

Is Building in a Special Hazard Zone

Flood Zone

Flood Certificate Company

Date of Determination

NFIP Map Number or Community Panel Number

NFIP Map Panel Effective/Revised Date

Flood Certificate Number

Notes

NFIP Non-Participating

NFIP Community Id

NFIP Community Name

NFIP State Code

NFIP County Name

NFIP Participation Status

NFIP Participation Start Date

NFIP Community FIRM Date

NFIP Map Panel

Map Panel Suffix

Map Identifier

Map Indicator

Data Revision Type

LOMR Date

Life of Loan

Partial Determination

Split Determination

Protected Area Indicator

Protected Area Designation Date

Add New Property Flood Certificates Entry

Appraisers Information

Appraiser 1

Appraiser First Name

Appraiser Last Name

Email

Appraiser Company

Phone

As Is Value

$

Appraiser Sales Comparison Approach

$

Appraiser Income Approach

$

Rehabbed Value

$

Monthly Rent

$

Job Types

Date Obtained

Appraisal Status

Requested Return Date

Rush Order

Yes No N/A

Order Date

Comments

Upload Appraisal

Appraisal Effective Date

Primary Appraisal ECOA Delivery Date

Appraisal Inspection Date

Expected Delivery Date

Expected Delivery Delay #

Supplemental Product Form Type 1

Effective Date 1

Supplemental Product ECOA Delivery Date 1

Supplemental Product Form Type 2

Effective Date 2

Supplemental Product ECOA Delivery Date 2

Supplemental Product Form Type 3

Effective Date 3

Supplemental Product ECOA Delivery Date 3

Add New Appraiser Entry

Borrower's Analysis Of Rental Income (Annualized)

Income Info

Residential Income

$

Residential Income Residential Calculate from Rent Roll?

Vacancy

$

Residential Vacancy Rate

%

Commercial Income

$

Commercial Income Commercial Calculate from Rent Roll?

Commercial Vacancy

$

Commercial Vacancy Rate

%

Other Income (Laundry,Parking,Other)

$

Other Income Vacancy

$

Other Income Vacancy Rate

%

Tenant Contributions

$

Tenant Contributions Vacancy

$

Tenant Contributions Vacancy Rate

%

Effective Gross Income

$

Expense Info

Real Estate Taxes

$

Insurance

$

HOA Fees

$

Other

$

Water & Sewer

$

Electric

$

Fuel

$

Repair and Maintenance

$

Legal/Professional Fees

$

Wages/Payroll

$

Miscellaneous

$

Common Area Utilities

$

Elevator Maintenance

$

Replacement Reserves

$

Other

$

Tenant Reimbursements

$

Management Fees

$

%

Total Expenses

$

Net Operating Income

$

Cap Rate

%

Reserves

$ 0.00

Reserve Factor

$

Debt Service Ratio

0.00

Cash Available To Service Debt

$0.00

Debt Service Ratio - PITIA

0.00

Gross Annual Rent of Largest Tenant

$

Seller Info

First Name

Last Name

Email

Phone

Address

City

State

Zip

VENDOR & EQUIPMENT INFORMATION

1 )

Vendor Phone

Vendor Contact

Equipment Type

Equipment Detailed Type

Vin or Serial Number

Year

Sale Price

New Used

Make

Model

Quantity

Mileage

Equipment Description

Pictures of Property

Select file to upload

Add Pictures Property

Foreclosure / Default Info

Has the borrower been 30+ days late in the past 12 months ?

Yes No NA

Is the mortgage currently behind?

Yes No NA

Has the borrower received a notice of foreclosure or default by the bank, attorney, or trustee?

Yes No NA

Type / Select the date Notice of Default received

Has client received notice of summons?

Yes No NA

Type / Select the date Notice of summons received

Type / Select Sales Date if provided by bank/attorney/trustee

Trustee Sale #

Jurisdiction

Index #

Attorney Information

First Name

Last Name

Firm Name

Email

Phone

Fax

Cell

Address

City

State

Zip

Trustee Information

First Name

Last Name

Firm Name

Email

Phone

Fax

Cell

Address

City

State

Zip

Notes

Loan Workout Q & A

Do you want to keep the property?

Yes No NA

Have you applied for a loan modification?

Yes No NA

Date of application

Date of modification

Please provide all details

Has the borrower filed for bankruptcy?

Yes No NA

Is the borrower behind on plan payments?

Yes No NA

Filing Date

What is the Bankruptcy disposition status?

Bankruptcy Case number

Date discharged

Was the mortgage debt reaffirmed?

Yes No NA

Are the property(s) included in the bankruptcy?

Yes No NA

Is this home currently listed for sale?

Yes No NA

For how long?

For Sale by Owner?

Yes No NA

Listing Realtor Name

Real Estate Agency

Listing Phone

Listing Price

$

Listing Date

Has the borrower received an offer on the property?

Yes No NA

Date of offer

Amount of offer

$

Does the borrower have more than one property?

Yes No NA

How many properties?

How many mortgages?

Are the property taxes currently delinquent?

Yes No NA

Delinquent tax total?

$

Which year(s) are delinquent?

Additional Questions

Is the property subject to any additional liens, encumbrances, or restrictions (i.e. Property Assessed Clean Energy Program aka PACE)?

Yes No

Are you borrowing any money for this real estate transaction or obtaining any money from a nother party, such as the seller or realtor, that you have not disclosed on this loan application?

Yes No

If Yes, what is the amount of this money?

$

Occupancy

Does the borrower intend to occupy the property as their primary residence?

Yes No

Have you had ownership interest in another property in the last 3 years?

Yes No

What type of property did you own?

How did you hold title to the property

Does the co-borrower intend to occupy the property as their primary residence?

Yes No

Do you have a family relationship or business affiliation with the seller of the property?

Yes No

Secondary Financing

Will there be a 2nd lien or borrowed money for down payment?

Yes No

Title Info

Current Name on Title

New Name on Title

Recording #

Title Order Number

Title Ordered Date

Title Report Date

Title Received Date

Borrower Vesting Information

Title Report

Title Exceptions

Title Info : 1

Title Rep First Name

Title Rep Last Name

Title Company

E-mail

Phone #

Cell

Fax

Toll Free

Title Address

Title City

Title State

Title Zip

Title Notes

Add Title Info

Attorney Info

Attorney Info : 1

Attorney Name

Attorney Last Name

Attorney Firm Name

Bar #

Attorney Phone

Attorney E-mail

Add Attorney Info

Escrow Info

Escrow Info : 1

Escrow Rep First Name

Escrow Rep Last Name

Company

E-mail

Phone #

Toll Free

Fax

Cell

Escrow #

Escrow Address

Escrow City

Escrow State

Escrow Zip

Add Escrow Info

General Contractor

First Name

Last Name

Email

Company Name

License Number

Phone

Website

Cell Number

Address

City

State

Zip Code

Toll Free

Financial Advisor

Financial Advisor : 1

First Name

Last Name

Name Of Company

Email

Phone

Address

City

State

Zip

Website

Financial Advisor Notes

Add Financial Advisor

Accountant Info

Accountant : 1

First Name

Last Name

Name Of Company

Email

Phone

Address

City

State

Zip

Website

Notes

Add Accountant

Insurance Advisor Info

Insurance Advisor Info 1

First Name

Last Name

Name of Company

E-mail

Phone

Address

City

State

Zip

Website

Insurance Rep Notes

Add New Insurance Advisor Info

Billing/Payment Information

Check

Checking ACT Bank Name:

Checking ACT Holder\'s Name on Account

Loan Servicer

Servicer Exception

Same as Mailing Address?

ACT Holders Address of Record with Bank

ACT Holders City

State

Zip

9 Digit Bank Routing Number

Checking ACT Number

Deposit Date

Account Holder Type

Account Type

Personal Checking Personal Savings Business Checking

Credit Card

Type of Card

Card #

Card Holders Name on Card

CVV #

Same as Mailing Address?

Card Holders Address

ACT Holders City:

State

Zip

Acknowledgements

You understand and agree that the information you have provided is true and correct and understand that this form is not an application for credit but a general inquiry as to our commercial mortgage lending products. Upon submission, our lending team will review your information and contact you to discuss potential options and next steps. Should you decide to move forward, a credit application process will follow, which will include the collection of additional information.

By checking this box I agree to the acknowledgement and terms and conditions . *

By checking this box I agree to the Terms and Conditions above

Name Of Borrower

Date (System Generated)

Name of Borrower Signing:

Reset Signature

By checking this box I agree to the Terms and Conditions above

Name Of Co Borrower

Date (System Generated)

Name of Co-Borrower Signing:

Reset CoBorrower Signature

Loan Officer/Mortgage Broker

Guarantor #1 Information

Guarantor #2 Information

Borrower Type/Entity Info

Sales Method

Fee Schedule

Equipment Info

Additional Guarantors

Demographic Information for Individual

Demographic Information for Co-Applicant

Guarantor #1 Background

Guarantor #2 Background

Borrower Experience

Typical Transactions

Co-borrower Experience

Financial Questions

Other Business/Affiliate Information

Assets (Include Borrower + Co-borrower amounts if any)

Total:

$

$

Total Est. Value

- Total Amt Owed

= Total Net Worth

$

- $

= $

Gifts or Grants

Gifts Or Grants : 1

Contingent Liabilities

Contingent Liabilities 1

Guarantor #1 Employment Information

Additional Employment Information : 1

Guarantor #2 Employment Information

Additional Employment Information : 1

Borrower Monthly Income

$ 0.00

Co-borrower Monthly Income

$ 0.00

$ 0.00

Borrower Monthly Expenses

Monthly Payment

Bal Owed

$

$

$

$

$

$

Co-borrower Monthly Expenses

Monthly Payment

Bal Owed

$

$

Liabilities

Partnerships

Partnerships 1

Current Mortgage(s) On Subject Property

Other New Mortgage Loans : 1

Loan Settings

Important Dates

Rehab Construction Info

Loan Request

$

%

%

%

%

%

%

$

%

%

%

%

%

Fees & Costs

Additional Loan Settings

Existing Mortgage Debt

Existing Mortgage Debt 1