Quick Application Form

What type of mortgage are you interested in?

Are you a Mortgage Broker or working with one?

Yes No

Please select your Mortgage Broker

Email Address

First Name

Last Name

Company Name

Phone Number

Are you a Loan Officer or working with one?

Yes No

Please select your Loan Officer

Email Address

First Name

Last Name

Company Name

Phone Number

Select Loan Program

SBA Loan product

Additional Desired Loan programs

Where are you in the process?

Lead Source

Broker/Referring Party

Sales Method

Retail Swiped

KEYED

ECOMM

MOTO

Fee Schedule

Visa/MasterCard/Discover/AXP Qualified Credit Card Discount Rate(for Tiered/Flat) %

Visa/MasterCard/Discover/AXP Qualified Credit Card Pass Thru I/C Plus

Qualified Check Card Discount Rate (for Tiered/Flat)

Qualified Check Card PassThru I/C Plus

Visa/MasterCard/Discover/AXP

Authorization Fee

Monthly Program Fee "Cash Discount"

Customer Service Fee

Monthly Minimum Fee

PIN Debit Transaction Fee

Batch Fee

Amex OPT Blue Qualified Rate

Amex OPT Blue Mid Qual

Amex OPT Blue Non Qual

Amex OPT Blue Pass Thru I/C Plus

Amex ESA #

AVS Transaction Fee

EBT Transaction Fee

EBT Account#

Amex Processing Fee

Other Fee

3 Tier Pricing Visa/MC/Disc/AXP Mid Qual

3 Tier Pricing Visa/MC/Disc/AXP Non Qual

Chargeback Fee

ACH Retrieval Fee

Tell Us About Your Experience

Does borrower have Fix & Flip or Buy & Hold experience?

Yes No

Number of years of experience?

Number of properties flipped in last 36 months

Property Type
Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address
City
State
Zip

Upload HUD

Property Type
Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address
City
State
Zip

Upload HUD

Property Type
Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Address
City
State
Zip

Upload HUD

Does borrower have ground up construction experience?

Yes No

# of years experience?

# of properties completed in last 36 months

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Entity Name

Ownership %

Exit

Monthly Rent

Sale Price

What type of mortgage are you interested in?

Give Us Some Information

Co-borrower Information

Do You Have an Business Entity

Sales Method

Fee Schedule

Equipment Info

Additional Guarantors

HMDA - (Borrower)

HMDA - (Co-Borrower)

Borrower Background

Co-borrower Background

Tell Us About Your Experience