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Capital Request

Your Information

Your Name: 
Email Address:Phone:

1. Critical Dates

Are There Any Critical Dates Which Must Be Met For This Project, E.G. 1031 Exchange, Contract Expiration Dates, Bank Note Due Dates? If Yes, Please Explain:

2. Loan Information

Loan Type:  
Property Type:  
Property Type(Other):  
Loan Amount:  
Appraised Value:Project Costs

3. Source and Use of Funds

Source of Funds
Use of Funds

4. Exit Strategy

If Not a Self-Amortizing Loan, How Will the Balloon Be Paid At the End of the Term:

5. Property Information

Type of Property:  
Property Street Address: 
City: County:
State:Zip Code:
Borrower's Date of Purchase:Purchase Price:
Borrower's Cash Investment in This Property to Date:
Borrower's Current Equity in This Property:
Borrower's Source of Equity:
Borrower's Current Debt against This Property:
Liens Or Back Taxes Owed On This Property:

6. Additional Collateral

Type of Property  
Property Street Address: 
State:Zip Code:
Current Value:  
1st Lien Balance:2nd Lien Balance:

7. Prior Turn Down

If Applicable, Please Explain Why Financing Could Not Be Obtained

8. Primary Borrower Information

Individual Corporation LLC Partnership Other
Name of Business:  
Borrower's Name:  
State:Zip Code:
Office Phone#: Fax#:
Cell Phone#:Add. Phone#:
E-Mail Address:  
Personal Credit Score:Personal Net Worth
(excluding this project):
Borrow's Prior Experience with This Type of Project:

9. Additional Information

Enter any additional information you would like considered in your request.