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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
:
Single Family Residence
Condominium
Townhouse
I-4 Plex
Land
Commercial
Other
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 Owen 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.