Borrowing Entity: ______________________________________________________
__Individual __ Partnership __ Corporation __ LLC __ Other/Specify:____________
Address ______________________________________________________________
Assets: ______________ Liabilities: ______________ Net Worth: _____________
Total Project Completion Value LTV. of Completed Value
The AS IS Value LTV. AS IS
Loan To Cost Total Cost of the Project
Amount of Dollars the Borrower is going to bring into the Project
Amount of Dollars the Borrower Has into the Project at this Time
Personal Guarantor
Name: ________________________________________________________________
Address: ______________________________________________________________
City
Phone # , Fax # , e mail address :
__________________________________________________________________________________
Assets: ______________ Liabilities: ______________ Net Worth: ______________
Gross Income: ______________ Cash On Hand: ______________
Property Information
Annual Gross Income: _______________ Annual Expenses: _______________
Net Operating Income: _______________
Use Of Proceeds
1) ________________________________________ $___________________
2) ________________________________________ $___________________
3) ________________________________________ $___________________
4) ________________________________________ $___________________
5) ________________________________________ $___________________
6) ________________________________________ $___________________
Total $___________________
Referring Broker: ______________________________ Phone #
Company: ____________________________________
Authorized Representative Of Borrower: __Yes __No
Total Broker Points: _______________
