1. Confidential Loan Application as of _________
1
Tax ID Number (TIN)_________________________________________________________________________________________
Corporation
Ownership: list all partners, co-owners or stockholders of significance
Name Title
(Own/Rent)________________________________________________________________________________________________
Date of Birth (MM/DD/YR)____________________________________________________________________________________
Social Security Number (SSN)_________________________________________________________________________________
LLC/Corporation Name______________________________________________________________________________________
Phone(______) _______-__________ Fax (______) _______-__________
LLC/Corporation Address_____________________________________________________________________________________
City______________________________________________ State _______________________ Zip _________________________
Type of Business __________________________________________________________ Date Established __________________
Partnership Sole Proprietorship
Limited Liability Corp. Other____________________
Type of Entity
(Circle One)
Percentage of Ownership Annual Compensation from Borrower
Email _____________________________________________________________________________________________________
Borrower/Guarantor(s) Information____________________________________________________________________________
Home Address______________________________________________________________________________________________
City______________________________________________ State _______________________ Zip _________________________
Number of Years at above address_____________________________________________________________________________
Home Phone(______) _______-__________
Cell Phone (______) _______-__________
Fax (______) _______-__________
Self-Employed (Yes/No)________________________________________________________________________________________
Business Phone (______) _______-__________
Business Fax (______) _______-__________
Employment Information
Employer Name_____________________________________________________________________________________________
Job Title___________________________________________________________________________________________________
Job Address________________________________________________________________________________________________
City______________________________________________ State _______________________ Zip _________________________
Years of Employment________________________________________________________________________________________
Yes No
Yes No
If Yes, please explain
Have you ever filed Bankruptcy or have you ever
been a member of an entity that has filed for
bankruptcy?
Have you ever been convicted of a felony?
Bankruptcy History
If Yes, please explain
Criminal History
2. Confidential Loan Application as of _________
2
Title Holder
Street
City
State
Zip Code
Multi-Fam(1 2 3 4) Retail Office Mixed Use
Industrial/Flex Hospitality Self-Storage Other
Estimated Total Sq Footage
# of Rooms/Offices/Units
# of Bathrooms
# of Garage/Parking Spaces
Purchase Price
Loan Amount
Loan to Purchase (LTP)
Closing Date
Taxes Insurance
Carrying Costs
Net Operating Income
Subject Property Information
Property Type
(Circle One)
Estimated Cost of Improvements Equity Other Sources Bank Loan Total Cost
Building Alterations
Building Improvements
Building Repairs
Repayment or Refinancing Debts
Closing Costs
Other {+}
Total Cost of Improvements
Est. Fair Market Value
(after improvements)
Please Attach a Detailed Construction Budget
{+}Specify: ____________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Loan Requested: $______________________________________________________________________________________________________
Estimated Project Budget
Description Estimated Market Value Existing Liens
$ $
$ $
$ $
Name, Address & SSN Net Worth Relationship
$
$
$
Collateral Offered for Loan
Personal Guarantees Offered
3. Confidential Loan Application as of _________
3
Salary, Bonuses & Commissions $ Income Taxes $
Dividends & Interest $ Other Taxes $
Rental & Lease Income $ Insurance Premiums $
Other Income $ Mortgage Payments $
Rent Payable $
Other Expenses $
Total $ Total $
Cash in Banks $ Notes Due to Banks $
Securities $ Other Notes Due $
Real Estate Owned $ Unpaid Taxes/Interest $
Mortgages & Contracts $ Real Estate Mortgage Payable $
Personal Property $ Rent Owed $
Net Worth of Business Owned $ Liens & Assessments Payable $
Other Assets $ Other Debts $
Total Assets $ Total Liabilities $
Gross Monthly Income Gross Monthly Expenses
Assets Liabilities
Assets & Liability Information
Financial Information
Fax (______) _______-__________
Email _____________________________________________________________________________________________________
Phone (______) _______-__________
Fax (______) _______-__________
Estimated Agent Commission $ _______________________________________________________________________________________
Insurance Agent_____________________________________________________________________________________________
Email _____________________________________________________________________________________________________
Phone (______) _______-__________
Phone (______) _______-__________
Fax (______) _______-__________
Real Estate Agent___________________________________________________________________________________________
Attorney___________________________________________________________________________________________________
Email _____________________________________________________________________________________________________
3rd Party Information
