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Useful Documents

Fillable Application in PDF
Fillable Application PDF- Spanish Version

Create Loan File

Client Info

File Type

Type name in the box to select File Type(s).

What kind of program are you looking for?

Subject Property

Present Occupancy

Are taxes escrowed?

Is Insurance escrowed?

Home value? (As-Is)

Borrower Info

First Name

Middle Name

Last Name

Borrower Email

Please Wait...

Secondary Email

Home Phone

Cell Phone

Fax

Cell Carrier

Preferred Communication

Is there a Co-borrower?

Alt. Phone #

Work Phone #

Address

Unit #

City

State

Zip Code

County

Country

Borrower Type/Entity Info

Borrower Type

Trust Type

Retirement Entity

General Business Info

Entity Name

Trade Name/DBA

Entity Type

Date Of Formation

Time in Business

State Of Formation

States Registered In

Federal Tax ID/EIN

Business License Number

Issuance Date

Expiration Date

State Issued

Other States Operating In

DBA Name(s)

Prior Business Name(s)

Organizational Ref #

Business Phone

Website Address

Business Address

Start Date at Location

Address

Address 2/Suite/Unit #

City

State

Zip Code

Is the billing address the same as above?

Billing Address

Billing City

Billing State

Billing Zip Code

Location

Urban Rural Suburban

Property Ownership

Value of Property?

Total Debt on Property?

Name of Lender(s)?

Landlord/Mortgage Contact Name

Landlord/Mortgage Phone

Rent/Mortgage Payment

Business Details

Business Type

# of employees currently

# of employees after loan

Business Category

Type of product or service sold

Naics Code

NAICS Code look up

Does your business sell a

Service Product

Is your Business

B2B B2C

Is your business home based?

Yes No

Do you take credit card payments?

Yes No

Terminal/ POS Make/Model

How many card processor banks do you have active?

Merchant Processing Bank Name(s)

Do you charge sales tax?

Yes No

How are employees paid?

Do you have more than one business location?

Yes No

How many locations?

Other Location Details & Addresses

Is the business a franchise?

Yes No

Name of Franchise

Point of Contact

Point of Contact Phone

Point of Contact E-mail

Website for Franchise

is your business seasonal?

Yes No

if Yes, what are the peak months?

Business Description

Do you have Business Reference(s)?

Yes No

Phone Name

Company

Fax

Business Financials

Average Monthly Credit Card Sales

Average Monthly Deposits

Annual Revenue

Annual Gross Profit

YTD-Net Business Income

Date of Operating Agreement

Gross Annual Revenues $

Gross Income Last Year

Net Income Last Year

Gross Income 2 years ago

Net Income 2 years Ago

Average Bank Balance

Has business ever filed for bankruptcy?

Yes No

Status of Business Bankruptcy

Recent NSFs

Does your business owe taxes for years prior to the current year?

Yes No

Estimated amount owed

Members/Officers (List all members with 20% ownership or more.)

Same as Borrower/Applicant Info Above

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Name

Title

% of Ownership

Annual Salary/Compensation

Address

Phone

Cell

SSN

DOB

Credit Score

Credit Score Date

Rent or Own

Monthly Rent Or Mortgage

Date moved into this address

Real Estate Value

Retirement Account(s) Balance

Cash/Savings/Stocks Balance

Credit Card(s) Balance

Mortgage(s) Balance

Auto loan(s) Balance

Total Net Worth

Marital Status

Unmarried Married Separated

Date of Marriage

Date of Divorce(If applicable)

Maiden Name

Full name of Spouse if not on mortgage

Drivers License State

Drivers License

Member TIN

Personal Guarantee for this loan

Yes No

Authorized signer for making loans

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Add More Members/Officers Info

Corporate Secretary Name

Notes

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

Equipment Info

Are you currently using a point of sale system?

Yes No

Software

Software Version

Does your Business have a Land Line?

Yes No

How will your new terminal connect to the internet?

Does your business location(s) have internet?

Yes No

Do you have WiFi?

Yes No

Do you know the password?

Yes No

What is your Wifi password?

Do you expect your EBT?

Yes No

What is your EBT number?

What would you like to have printed on the bottom of the receipt?

Is the equipment for a restraunt?

Yes No

Do you want Tips Added On?

Yes No

Do you want the customer to fill out Tip on Receipt or at cashier when they checkout only?

Suggested % #1

Suggested % #2

Suggested % #3

Do you want your Terminal to automatically Batch out? (Not recommended for restraunts. Once it batches out, unentered Tips will be lost).

Yes No

At What Time?

Shipping Address

Shipping City

Shipping State

Shipping Zip Code

Borrower Background

Are you a U.S. Citizen?

Yes No

Origin

Visa Status

Has the borrower been declared bankrupt within the past 7 years?

Yes No

Status of Personal Bankruptcy

If Yes, identify the types of bankruptcy

Please provide filing date, current status, properties included, etc...

Are there any outstanding judgments against the borrowers?

Yes No

(If Yes, Provide explanation below.)

Do you have any active lawsuits against you?

Yes No

(If Yes, Provide explanation below.)

Have you had or currently have any property tax liens?

Yes No

(If Yes, Provide explanation below.)

Has the borrower directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?

Yes No

Status of Foreclosure

(If Yes, Provide explanation below.)

Is the borrower presently delinquent or in any default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee

Yes No

(If Yes, Provide explanation below.)

Have you ever been convicted of a felony or other fraud related crimes?

Yes No

(If Yes, Provide explanation below.)

Are you in a Civil Union or a Domestic Partnership, or do you have a non-borrowing spouse, or are you a party to a Designated Beneficiary Agreement?

Yes No

(If Yes, Provide explanation below.)

Within the past 7 years, have you completed a pre-foreclosure sale, whereby the property was sold to a third party and the Lender agreed to accept less than the outstanding mortgage balance due?

Yes No

Have you had property foreclosed upon in the last 7 years?

Yes No

Have you previously had a short sale?

Yes No

When was the short sale?

Please explain the circumstances of the short sale

Background Explanation

Income tax returns filed through

Are any returns currently being audited or contested?

Yes No

what years (s)

Have you drawn a will?

Yes No

Please furnish the name of the executor(s) and year will was drawn

Have you ever had a financial plan prepared for you?

Yes No

Is there a line of credit or unused credit facility at any other institution(s)?

Yes No

Please indicate where, how much, and name of banker

Do you anticipate any substantial inheritances?

Yes No

Please Explain

SBA Questions

Purpose of the loan:

Payroll Rent/Mortgage Interest Utilities Other

Detailed Explanation

Is the Applicant (if an individual) or any individual owning 20% or more of the equity of the Applicant subject to an indictment, criminal information, arraignment, or other means by which formal criminal charges are brought in any jurisdiction, or presently incarcerated, or on probation or parole?

Yes No

Detailed Explanation

Have you been arrested in the past six months for any criminal offense?

Yes No

Detailed Explanation

Within the last 5 years, for any felony, has the Applicant (if an individual) or any owner of the Applicant 1) been convicted; 2) pleaded guilty; 3) pleaded nolo contendere; 4) been placed on pretrial diversion; or 5) been placed on any form of parole or probation (including probation before judgement)?

Yes No

Detailed Explanation

Has an application for the loan you are applying for now ever been submitted to SBA or to a Certified Development Company or lender in connection with any SBA program?

Yes No

Detailed Explanation

Is the Applicant a franchise that is listed in the SBAs Franchise Directory?

Yes No

Detailed Explanation

Does the Small Business Applicant have any Affiliates?

Yes No

Detailed Explanation

Has the Small Business Applicant and/or its Affiliates ever filed for bankruptcy protection?

Yes No

Detailed Explanation

Is the Small Business Applicant and/or its Affiliates presently involved in any pending legal action?

Yes No

Detailed Explanation

Is the Applicant or any owner of the Applicant presently suspended, debarred, proposed for debarment, declared ineligible, voluntarily excluded from participation in this transaction by any Federal department or agency, or presently involved in any bankruptcy?

Yes No

Detailed Explanation

If you are at least a 50% or more owner of the applicant business, are you more than 60 days delinquent on any obligation to pay child support arising under an administrative order, court order, repayment agreement between the holder and a custodial parent, or repayment agreement between the holder and a state agency providing child support enforcement services? .

Yes No

Detailed Explanation

Has the Small Business Applicant and/or its Affiliates ever obtained a direct or guaranteed loan from SBA or any other Federal agency or been a guarantor on such a loan?

Yes No

Is any of the financing currently delinquent?

Yes No

Detailed Explanation

Did any of this financing ever default and cause a loss to the Government?

Yes No

Detailed Explanation

Are any of the Small Business Applicants products and/or services exported or is there a plan to begin exporting as a result of this loan?

Yes No

Provide the estimated total export sales this loan will support:

Is the Small Business Applicant using (or intending to use) a packager, broker, accountant, lawyer, etc. to assist in (a) preparing the loan application or any related materials and/or (b) referring the loan to the lender?

Yes No

Detailed Explanation

Are any of the Small Business Applicants revenues derived from gambling, loan packaging, or from the sale of products or services, or the presentation of any depiction, displays or live performances, of a prurient sexual nature?

Yes No

Detailed Explanation

No SBA employee, or the household member (see definition on page 1) of an SBA employee, is a sole proprietor, partner officer, director, or stockholder with a 10 percent or more interest, of the Applicant.

Yes No

Detailed Explanation

No former SBA employee, who has been separated from SBA for less than one year prior to the request for financial assistance, is an employee, owner, partner, attorney, agent, owner of stock, officer, director, creditor or debtor of the Applicant.

Yes No

Detailed Explanation

No member of Congress, or an appointed official or employee of the legislative or judicial branch of the Federal Government, is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or household member of such individual, of the Applicant.

Yes No

Detailed Explanation

No Government employee having a grade of at least GS-13 or higher is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or a household member of such individual, of the Applicant

Yes No

Detailed Explanation

No member or employee of a Small Business Advisory Council or a SCORE volunteer is a sole proprietor, general partner, officer, director, or stockholder with a 10 percent or more interest, or a household member of such individual, of the Applicant.

Yes No

Detailed Explanation

Have you, or any business you controlled, ever filed for bankruptcy protection?

Yes No

Detailed Explanation

Is the United States the principal place of residence for all employees of the Applicant included in the Applicants payroll calculation above?

Yes No

Detailed Explanation

Do any of your employees earn more than $100,000/year?

Yes No

If Yes, Did you calculate your estimated monthly payroll using the cap of 100,000 per employee?
Detailed Explanation

Has the Applicant, any owner of the Applicant, or any business owned or controlled by any of them, ever obtained a direct or guaranteed loan from SBA or any other Federal agency that is currently delinquent or has defaulted in the last 7 years and caused a loss to the government?

Yes No

Detailed Explanation

Are you, or any business you control, presently involved in any legal action (including divorce)?

Yes No

Detailed Explanation

Has the Business received an SBA Economic Injury Disaster Loan between January 31, 2020 and April 3, 2020?

Yes No

Loan Amount

Detailed Explanation

Yes No

Detailed Explanation

Other Business/Affiliate Information

Company Name

Tax Id/EIN #

Legal Owners/Title/Ownership %

# of employees

Years in Business

Has applied for SBA loans?

Yes No

Description

Add Other Business Info

How many W-2 Employees do you have?

How many W-2s did you issue for 2020?

When was your company started?

Did you operate under full or partial suspension due to government order?

No Partial Suspension Full Suspension

How your business was impacted during the partial or full shutdown

What quarters were you affected? (If not sure leave blank)

Please provide gross receipts of each quarter excluding any PPP funds if they are included as revenue

Q1 2019

Q2 2019

Q3 2019

Q4 2019

Q1 2020

Q2 2020

Q3 2020

Q4 2020

Q1 2021

Q2 2021

Q3 2021

Q4 2021

Did any of your vendors operate under full or partial suspension due to government order that affected your ability to do business?

No Partial Suspension Full Suspension Not Sure

How your business was impacted during the partial or full shutdown

What quarters were you affected due to vendor delays

Please provide gross receipts of each quarter excluding any PPP funds if they are included as revenue

Q1 2019

Q2 2019

Q3 2019

Q4 2019

Q1 2020

Q2 2020

Q3 2020

Q4 2020

Q1 2021

Q2 2021

Q3 2021

Q4 2021

In 2020, which quarters experienced losses of at least 50% relative to the same quarter in 2019? If not, sure please leave blank

In 2021, which quarters experienced losses of at least 20% relative to the same quarter in 2019? If not sure, please leave blank

If you did receive a PPP loan(s), what was the amount(s)?

Draw 1

Draw 2

If you received a PPP loan(s), did you receive PPP loan forgiveness?

Draw 1

Yes No

Draw 2

Yes No

If you did have PPP loan forgiveness, what was the forgiven amount(s)?

Draw 1

Draw 2

Who is your payroll service provider?

Have you already claimed any Employee Retention Credits?

Yes No

If Yes, which quarter(s) and with which company?

Are any employees that are family members or 50%+ owners? If so, please provide names

Have you started any other businesses since Feb 15th 2020 with annualized revenues of less than $1,000,000 and that has active W-2 employees?

Do you have any other existing businesses with active w-2 employees? If yes, please let business entity names and number of W-2 employees

Borrower Experience

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

Yes No

# of years of experience?

# of properties completed in last 36 months

List 3 examples of past deals:

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Does borrower have ground up construction experience?

Yes No

# of years experience?

# of properties completed in last 36 months

List 3 examples of past deals:

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Are you a builder/developer?

Yes No

Do you have a GC on staff, or do you hire a third-party GC to complete rehab/construction?

Yes No

Does borrower have experience selling properties without construction (e.g., wholesaling)?

Yes No

# of years experience?

# of properties completed in last 36 months

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Property Type

Purchase date

Purchase Price

Amount Financed

Rehab Budget

Holding Title As

Ownership %

Ownership Status

Exit

Monthly Rent

Sale Price

Sale Date

Address

City

State

Zip

Unit/Suite #

Outcome/Profit

Upload HUD

Does borrower have any projects currently in progress?

Yes No

How many?

Does borrower own investment properties?

Yes No

How many?

Is borrower a member of an investment club or group?

Yes No

Name of Group/Club?

Do you have any professional licenses?

Yes No

Select Professional license

License #

Are you a full time real estate investor?

Yes No

How much liquid assets does borrower currently have?

Primary investment strategy

Describe Your Overall Real Estate Investment Experience

Primary investment strategy Explain

Track Record

Typical Transactions

Amount of financing requested

Amount of financing requested To

Typical purchase price

Typical purchase price To

Typical construction costs

Typical construction costs To

Typical sale price

Typical sale price To

No. of construction draws per project

No. of construction draws per project To

Months from purchase date to first construction draw

Months from purchase date to first construction draw To

Months from purchase date until construction complete

Months from purchase date until construction complete To

Months from purchase date to sale date

Months from purchase date to sale date To

No. of such projects that you will do at time

No. of such projects that you will do at time To

In which geographic areas do you intend to focus on the next 12-24 months?

Is there a Non-Borrower Contributor?

Non-Borrower Contributor

Name

Date Of Birth

SSN Number

Email Address

Monthly Contribution

Co-borrower Information

First Name

Middle Name

Last Name

Email Address

Please Wait...

Home Phone

Cell Phone

Fax

Mobile Service Provider

Same as borrowers address?

Address

Unit #

City

State

Zip Code

County

Rent or Own

Is the Co-Borrower Guaranteeing the loan?

Yes No NA

Length of time at address

Has the borrower resided at the present address for less than two years?

Yes No

Previous Address

Previous Unit #

Previous City

Previous State

Previous Zip Code

Previous County

Rent or Own

Mailing Address

Same as borrowers mailing address?

Mailing Address

Mailing Unit #

Mailing City

Mailing State

Mailing Zip

Mailing County

Personal Info

Date Of Birth

Place Of Birth

Social Security Number

Driver License State

Driver License Number

Driver License Issuance Date

Driver License Expiration Date

Marital Status?

Unmarried Married Separated

Married to Borrower?

Yes No

Citizenship

U.S. Citizen Perm Resident Non-Perm Resident Foreign National

Equifax Score

Mid Fico Score

Transunion Score

Experian Score

Credit Score Range

Co-borrower Background

Are you a U.S. Citizen?

Yes No

Origin

Visa Status

Has the borrower been declared bankrupt within the past 7 years?

Yes No

Please provide filing date, current status, properties included, etc...

Are there any outstanding judgments against the borrowers? (If Yes, Provide explanation below)

Yes No

(If Yes, Provide explanation below.)

Do you have any active lawsuits against you?

Yes No

(If Yes, Provide explanation below.)

Have you had or currently have any property tax liens?

Yes No

(If Yes, Provide explanation below.)

Has the borrower directly or indirectly been obligated on any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?

Yes No

(If Yes, Provide explanation below.)

Is the borrower presently delinquent or in any default on any Federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee

Yes No

(If Yes, Provide explanation below.)

Have you ever been convicted of a felony or other fraud related crimes?

Yes No

(If Yes, Provide explanation below.)

Are you in a Civil Union or a Domestic Partnership, or do you have a non-borrowing spouse, or are you a party to a Designated Beneficiary Agreement?

Yes No

(If Yes, Provide explanation below.)

Background Explanation

Co-borrower Experience

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

Yes No NA

# of years of experience?

List 3 examples of past deals:

Outcome/Profit

Upload HUD

# of properties completed in last 36 months

Address

Outcome/Profit

Upload HUD

Address

Outcome/Profit

Upload HUD

Does borrower have ground up construction experience?

Yes No NA

# of years experience?

List 3 examples of past deals:

Outcome/Profit

Upload HUD

# of properties completed in last 36 months

Address

Outcome/Profit

Upload HUD

Address

Outcome/Profit

Upload HUD

Does borrower have experience selling properties without construction (e.g., wholesaling)?

Yes No NA

# of years of experience?

# of properties completed in last 36 months

List 3 examples of past deals:

Outcome/Profit

Upload HUD

Address

Outcome/Profit

Upload HUD

Address

Outcome/Profit

Upload HUD

Do you have any projects currently in progress?

Yes No NA

How many?

Does borrower own investment properties?

Yes No NA

How many?

Is borrower a member of an investment club or group?

Yes No NA

Name of Group/Club?

Do you have any professional licenses?

Yes No

Select Professional license

License #

Are you a full time real estate investor?

Yes No

How much in liquid reserves?

Primary investment strategy

Primary investment strategy Explain

1st Lien Current Mortgage Scenario

Loan Type	Terms	Rate %	Current Unpaid Principal Balance $	Original Loan Amt $	Loan Number	Notice of Acceleration
						(MM/DD/YYYY)
		Months Behind (Manual Entry)	Last Payment Made	Days Behind
			(MM/DD/YYYY)
Original Lender		Current Lender/Servicer		Mortgage Type		Mortgage Investor/Owner

Monthly P + I Payment $	Monthly Taxes $	Monthly Property Insurance $	Flood Insurance $	Priv. Monthly Mortg. Insurance $	Monthly H.O.A Fees $	= Total Monthly Payment

Past Due Interest	Out of Pocket Escrow Adv $	Projected Escrow Adv during Trial $	Past Due Mtg. Ins $	Past Due H.O.A $	Late Fees (Not Included) $

2nd Lien Mortgage Scenario

2nd lien Loan Type	Terms	Rate %	Current Unpaid Balance $	Original Loan Amount $	Payment $	Loan Number	Past Due Interest	Last Payment Made
								(MM/DD/YYYY)
Current Lender/Servicer			Months Behind (Manual Entry)		Days Behind (Based on last payment date)

Original Lender			Mortgage Type	Mortgage Investor/Owner

HMDA - (Borrower)

Do you wish to furnish this information?

Yes No N/A

What is your Ethnicity:

Hispanic or Latino

Mexican, Puerto Rican, Cuban, Other Hispanic or Latino

Mexican Puerto Rican Cuban Other Hispanic or Latino

Print Origin For example: Argentinean, Colombian, Dominican, Nicaraguan,Salvadoran, Spaniard, and so on

Not Hispanic or Latino Not Disclosed

What is your Race:

American Indian or Alaska Native Asian

Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Other Asian

Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian

Print Race For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

Black or African American Native Hawaiian or Other Pacific Islander

Native Hawaiian, Guamanian or Chamorro, Samoan, Other Pacific Islander

Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander

Print Race For example: Fijian, Tongan, and so on.

White Not Disclosed

Sex:

Male Female Not Disclosed

Veteran an option for veteran

Non-Veteran Veteran Service-Disabled Veteran Spouse of Veteran Not Disclosed

HMDA - (Co-Borrower)

Do you wish to furnish this information?

Yes No N/A

What is your Ethnicity:

Hispanic or Latino

Mexican, Puerto Rican, Cuban, Other Hispanic or Latino

Mexican Puerto Rican Cuban Other Hispanic or Latino

Print Origin For example: Argentinean, Colombian, Dominican, Nicaraguan,Salvadoran, Spaniard, and so on

Not Hispanic or Latino Not Disclosed

What is your Race:

American Indian or Alaska Native Asian

Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, Other Asian

Asian Indian Chinese Filipino Japanese Korean Vietnamese Other Asian

Print Race For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

Black or African American Native Hawaiian or Other Pacific Islander

Native Hawaiian, Guamanian or Chamorro, Samoan, Other Pacific Islander

Native Hawaiian Guamanian or Chamorro Samoan Other Pacific Islander

Print Race For example: Fijian, Tongan, and so on.

White Not Disclosed

Sex:

Male Female Not Disclosed

Veteran

Non-Veteran Veteran Service-Disabled Veteran Spouse of Veteran Not Disclosed

Client Notes PrintFriendly

Personal Information

Do you own the majority of the business?	Yes No
Owner's Name
% Owned

Business Information

Business Name
Business Name (DBA)
Business Legal Name
Business Tax ID
Business Entity Type
Website
Industry
Are your clients businesses or consumers ?	Businesses Consumers

Financial Information

Months in business?
Average monthly revenue ($)
Credit score
Annual Gross Revenue ($)
Monthly Bank Deposit Volume ($)
Average Daily Bank Balance ($)
Do you have invoices to factor?	Yes No
How much ($) ?
Requested Advance Amount ($)
Requested Term Length (in Months)
How do you plan to use your funding?
Does the business accept credit cards?	Yes No
Does the business have exsisting financing?	Yes No
On your most recent business tax return, did you show a net profit or a net loss?	Profit Loss
Amount?
Do you own collateral?	Yes No
Sum of monthly recurring debt payments

Q+A

Credit Check Total Username		Credit Check Total Password
Experian Score		Equifax Score
Transunion Score		Monthly Income before Taxes?
Monthly Income after Taxes?		Are you employed?	Yes No
Can you prove income with paystub, W2, and income tax return?	Yes No	Number of Months at Current Job?
Have you or any family member served in the US Military?	Yes No	Do you own a business ?	Yes No
Type of Business		When did you incorporate?
Do you own or rent?	Own Rent	Credit Issues
Amount Desired?		Reason for Funds
Comments
Who Referred You?