Personal Info

* Full Name

* Company

* Email

* Phone

Work Phone

Fax

* Address

* City

* State

* Zip Code

Reach Me By Home Phone
Work Phone
false

Property Info

* Approximate Value $

* Purchase Price $

* Approx. Purchase Date

Foreclosures, Bankruptcies, Leins, or Judgements Yes
No

* Property Type (select) Amusement Park Apartment Building Dealership-Car Lot Auto Repair Commercial or Rental Building Gas Station Golf Course Industrial Building Mixed Use Property Office Building Office Condo Parking Garage Restaurant Shopping Center Special Use Property Tennis Club Church Other

Does borrower currently live on the property Yes
No

* Description

* Property Address, City & State

Net Rentable Area

Number of Units

Number of Vacancies

Annual Property Income $

Does borrower own any other Real Estate? Yes
No
Unsure

Existing First Trust Deed

Present Balance $

Original Balance $

Monthly Payment $

My Payments are: Current
Past Due

Interest Rate %

Term

Existing Second Trust Deed

Present Balance $

Original Balance $

Monthly Payment $

My Payments are: Current
Past Due

Interest Rate

Term

Loan Quote Request

* Requested Loan Type (select) 1st Mortgage 2nd Mortgage 3rd Mortgage

* Borrower's Credit (select) Perfect Decent Average Bad

* Amount Requesting $

* Referral Fee Requested $

* Purpose for Loan (select) Purchase Maturing Loan - No Cash Out Maturing Loan - Cash Out Cash Out Refinance Renovation or Expansion Bills Leisure Business Investment Personal Other

Amount of Cash Down (if purchase) $

Amount of Carryback (if applicable) $

* Desired Term (select) 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 year

Other Information, Comments or Issues

* Info & Comments

* Type the text you see to the right (verifies you are human)