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Please fill out the form below to get started. The more complete and accurate the information the faster we are able to assist you. Please allow 3 - 5 business days for a response from our customer support staff.
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Borrower Information: |
| First Name: |
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Example: John |
| Last Name: |
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Example: Doe |
| Address: |
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Example: 123 Smart Lane |
| City: |
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Example: Beverly Hills |
| State: |
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Example: CA |
| Zip: |
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Example: 90210 |
| Phone (Daytime): |
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Example: 555-555-5555 |
| Phone (Evening): |
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Example: 555-555-5555 |
| Fax: |
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Example: 800-555-1212 |
| Email: |
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Example: johndoe@webaddress.com |
| Website: |
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Example: www.mywebsite.com |
| Your Credit Rating: |
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Example: Excellent |
| Best Time To Contact: |
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Example: Evening |
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Property Information: |
| Property Address: |
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Example: 123 State Street |
| Property City: |
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Example: Hollywood |
| Property State: |
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Example: CA |
| Property Zip: |
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Example: 90899 |
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Property Description: |
| Property Location: |
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Example: Suburbs, Rural, etc.., |
| Describe Property: |
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| Current Balance on Mortgage: |
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Example: $129,000.00 |
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Loan Amount Requested: |
| How did you establish value: |
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| Loan Type: |
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Example: Single family, Multi-Family |
| Purpose of Loan: |
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Example: New Property Acquisition, Rehab, etc.., |
| Requested Amount: |
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Example: $250,000.00 |
| Requested Term: |
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Example: 36 Months |
| Estimated Appraised Value: |
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Example: $350,000.00 |
| Appraisal Date: |
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Example: 11/01/2007 |
How Do You Plan To
Payoff/Refinance The Loan: |
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| When Do You Need Us To Fund: |
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Example: 03/15/2009 |
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Additional Comments: |
| Comments: |
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Digital Signature: |
By signing and submitting this form I hereby attest the information contained herein is true to the best of my knowledge. I understand that by submitting false information I will be held responsible for any inacurracies in this form that may result in disqualification of this application.
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Signature: |
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Example: John E. Doe |
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