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LOAN REQUEST FORM



 

 
 
Borrower Name
 
Co Borrower Name
 
 
Home Phone #:
Cell Phone #:
Best Contact #:
  
 
  Email Address:
 
Present Address
 
City:
State:
Zip Code:


  
 
Loan Residential Construction Commercial 		 
 
Loan Type Purchase Refinance 		 
 

Property Type:   


 
  If other please explain :
 
 
If Commercial or Business please describe:
  
 


If Purchase

Purchase price:

 Estimated Value of Property:

 Down Payment (If any):
 
If Refinance

Estimated Value of Property:

 Amount Owed on Property

Cash Out Requested (If any):
 
If Construction

Builder's Name:

 Builder's Phone #:

 
Borrower's Information

  Estimated Gross Yearly Income

Borrower::

 Co Borrower:

 
Estimated Liquid Assets

Borrower::

 Co Borrower:

 
Estimated Credit Score

Borrower::

 Co Borrower:

 

The Story :
Tells us what you would like to do and why.