Loan Officer/Mortgage Broker 
Yes No
Borrower Info

Yes No
Mailling Address


Personal Info
 Unmarried  Married  Separated
 U.S. Citizen  Perm Resident Alien  Non-Perm Resident Alien
Yes No
 Currently serving on active duty
 Currently Retired, discharged, or separated from service
 Non-activated member of the Reserve or National Guard
 Surviving Spouse
Borrower Background
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
SBA Questions
$

$
Payroll Rent/Mortgage Interest
Utilities Other
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
$
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No
Yes No

Borrower Experience
Yes No

List 3 examples of past deals:

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
Yes No
Yes No

List 3 examples of past deals:

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
Yes No

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
Yes No
Yes No
Yes No
Yes No
Yes No
Typical Transactions
to
to
to
to
to
to
to
to
to
Assets (Include Borrower + Co-borrower amounts if any)

Type

Estimated Value ($)

Amount Owed ($)

 
 
 
 
 
 
 

Total:

$

$

Total Est. Value

- Total Amt Owed

= Total Net Worth

$

- $

= $

Schedule of Real Estate
Yes No
Yes No
Additional Guarantors
Yes No
Business Entity
Yes No
`

  General Business Info

 

  Location/Property Details


Urban Rural
$
$

  Business Details

Service Product
B2B B2C
Yes No
Yes   No
Yes No
Yes No
Yes No

  Business Financials

$
$
$
$

Members/Officers

(List all members with 20% ownership or more.)
Same as Borrower/Applicant Info Above
   
Name
Title
% of Ownership
%
Address
Phone
Cell
SSN
DOB
Email
Drivers License
Drivers License State
Add More Members/Officers Info
Subject Property Details

  Property Location

Urban   Rural

  Property Characteristics

 Yes      No

  Property Details

In Month

  Property Access

Yes No
Foreclosure / Default Info
 Yes  No  NA
 Yes  No  NA
 Yes  No  NA
 Yes  No  NA
Attorney Information
 
Trustee Information
 
1st Lien Current Mortgage Scenario
$
$
Monthly Payment Details
$
$
$
$
$
$
$
$
$
$
$
$
Rep Name & all other contact info....
2nd Lien Current Mortgage Scenario
$
$
$
Rep Name & all other contact info....
VENDOR & EQUIPMENT INFORMATION
 
Loan Terms
$
%
%
%
Yes No
 Current Loan Balance
 Total Loan Amount     
 Set Manual Payment
$ 0
Yes No
Yes No
Yes No
$
$

$


$
$
$

%

%

%

Subject Property Cash Flow (Annualized) 
$
 
$  
%
$  
 
$
 
$  
  %
$  
$
%
$  
$
Additional Questions
Yes No
Yes No
Yes No
$
Yes No
Yes No
Yes No
Yes No
$
Yes No
$
Yes No
$
Title Info
Attorney Info
Insurance Company Info
Escrow Info
HMDA - (Borrower)
Yes No NA
Hispanic or Latino Not Hispanic or Latino
 American Indian  Asian
 Black or African American
 Native Hawaiian or Other Pacific Islander
 White
Male Female
Borrower Employment Information
I have ownership share of less than 25%
I have ownership share of 25% or more
Weekly   Monthly   Every 2 weeks   Twice a month