• First Name *
  Last Name *
  Email Address *
  Phone *
  Purpose of Loan Purchase OnlyAcquisition & RehabCash Out RefinanceConstruction OnlyStop Foreclosure/BankruptcyDebt Consolidation Refi
  I am BorrowerReferral PartnerCapital Investor
  Subject Property Address
  City
  State * Please select oneAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDistrict of ColumbiaDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming
  Zip Code
  Is This Your Principal Residence? *

  Yes No
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• Type of Property Single Family ResidenceTownhouseCondoMulti Family (2-4 Units)Apartment Bldg (4 Units)Shopping CenterOffice BuildingBar/RestaurantLot/LandIndustrialOther
  Requested Loan Amount
  Purchase Price (if purchase)
  Estimate Current Value of Subject Property
  Estimated Value After Rehab (if Applicable)
  Estimated Repair Cost (If Applicable)
  How Would You Rate Your Credit? Please select oneExcellentGoodFairBelow AveragePoorI Don't Know
  Credit Score
  Do You Have Any Current Loans On The Subject Property? No1st Mortgage2nd Mortgage1st & 2nd Mortgage
  If Yes, How Much Do You Owe (for all loans)?
  Exit Strategy
  Comments/Questions