Name:
Address:
City:
State:
Zip :
Company :
Work Phone:
Home Phone:
Fax :
E-mail:
1. Amount of Loan?
2. Type of Property as Collateral?
Commercial
Residential
3. Borrowers opinion of Value:
If Income Property, monthly gross rents:
Expenses:
4. Balance Owed Against Property?
Yes
No
1st TD:
Lender:
2nd TD:
Lender:
5. When was property purchased?
Purchase Price:
6. Bankruptcies?
Yes
No
No Judgements?
Yes
No
7. Please put any questions or comments you may have in the box . We will contact you as soon as possible.
