Summary Intake Form

Borrower Name:

Company Name (LLC, C or S Corp):

City/State/Zip:

Email Address:

Borrower's Credit Score (FICO):

Business Address:

Cell Phone:

Website:

Amount of Financing Requested?

Purpose of Loan:

Purchase or Refinance?
Select OnePurchaseRefinance

Property Type:

Rehab Type:

As Is Value:

As Repaired Value:

Description of Real Estate:

Address:

Borrowers Current Equity in Property?

Any special issues, problems, needs or timing requirements?:

Property Cash Flowing? (if so, provide cash flow spreadsheet):

Attach File:

Borrower's Occupation:

Prior Project Experience:

Net Worth or Financial Strength of Primary Principals, (excluding this project, in US Dollars):

Primary Principal’s last 3 years’ average income:

Exit Strategy (please give as much detail as possible):

What has been done thus far to secure financing?:

Your Full Name:

Today's Date: