Online Application

Borrower Information:

Entity Type

Company Name

First Name

Last Name

Primary Phone

Alternative Phone

Email Address

Email Confirm

Social Security #

Social Security # Confirm

Date of Birth (mm/dd/yyyy)

Marital Status

Number of Years in Real Estate

Investment Homes Previously Purchased

Employer Information:

Employer Name

Employer Phone

Position/Title

Years on This Job?

Monthly Income

Self Employed? Self Employed? Yes No

Years in Line of Work?

Former Employer:

Employer

Employer Phone

Position/Title?

Years on This Job?

Monthly Income?

Co-Borrower:

Co-Borrower? Co-Borrower? Yes No

Co-Borrower Information:

Entity Type

Company Name

First Name

Last Name

Primary Phone

Alternative Phone

Email Address

Email Confirm

Social Security #

Social Security # Confirm

Date of Birth (mm/dd/yyyy)

Marital Status

Number of Years in Real Estate

Investment Homes Previously Purchased

Co-Borrower Address:

Same Address as above? Same Address as above? Yes No

Address

City

State

ZIP Code

Own or Rent? Own or Rent? Own Rent

Number of Years?

Co-Borrower Former Address:

Address

City

State

ZIP Code

Own or Rent? Own or Rent? Own Rent

Number of Years?

Co-Borrower Employer Information:

Employer

Employer Phone

Position/Title?

Years on This Job?

Monthly Income

Self Employed? Self Employed? Yes No

Years in Line of Work?

Co-Borrower Former Employer Information:

Employer

Employer Phone

Position/Title

Number of Years?

Monthly Income

Loan Information:

Desire Closing Date (mm/dd/yyyy)

Purchase Price

Cost of Repairs

After Repair Value

Expected Project Completion Date (mm/dd/yyyy)

Do You Have a Property in Mind? Do You Have a Property in Mind? Yes No

Address

City

State

ZIP Code

Personal Financial Balance Sheet:

List Additional Assets:

Checking

Savings

401k/IRA

Stocks/Bonds

List Additional Liabilities:

Mortgage Loan (Total Balance)

Mortgage Loan (Monthly - PITI)

Credit Card Debt (Total)

Credit Card Debt (Monthly)

Car Loans (Total)

Other Loans

Additional Information:

Please add any additional information (multi-unit, foreclosure, etc.,)

Source of Business:

How Did You Hear About Us?

Please Specify

Credit Authorization

By checking the box below, I/We certify that everything stated in this application and any attached documents is true and correct. I/We hereby authorize creditor to check my/our credit history, to obtain a Consumer Credit Report for the purpose of evaluating this application for credit, and to answer questions others may ask the creditor about my credit record with the creditor. I/We also authorize the creditor to obtain any other information of public record pertaining to assets and other information deemed necessary in the review of this loan application and any other loan(s) or accounts I/We may have with the creditor at any given time. Applicant will promptly notify Creditor of any subsequent changes which would affect the accuracy of this Statement. Creditor is further authorized to answer any questions about Creditor's experience with Applicant. Applicant is aware that any knowing or willful false statements regarding the value of the above property for purpose of influencing the actions of Creditor can be a violation of federal law, 18 U.S.C $1014, and may result in a fine or imprisonment or both.

Applicant declares that he/she has read and understands the above statement

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