Referral Partner Password (if applicable)
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Referral Partner Name
  Date   
/   Borrower Name
/   Contact Name (if different)

Corporation  LLC  Partnership  Individual Condo
Other  Explain

  Address
  City
  ST
  Zip

  Home Phone
  Business Phone
  Fax
  E-Mail
  Name of borrower if different from above

Property to be financed
Address
  City
  ST
  Zip

Estimated sq. feet or number of units

Type of loan: 
Refinance:  Acquisition: Construction / Renovation

Please leave out what does not apply:

$  Loan amount Requested
$  Current estimated value of property
$  Estimated value at completion; 
                             (if renovation/const.)
$  Amount of equity invested by borrower
    Date entered into contract; (if acquisition)
    When property purchased
$  Purchased price; (if new acquisition)

$  Existing mortgages:   Paid current: Yes No
$  Other liens to payoff

$  Current gross income of property
$  Estimated gross income at completion;
                             (if renovation/const.)
$  Current estimated operating expenses (do not include
                             current mortgage expenses)
$  Net Income;  (before debt service)
    Last 12 months average occupancy %
Owner occupied:  Yes  No  (If yes what % )

Comments:  Please include a brief comment on property, use of proceeds, credit and borrower.  The more you share, the faster we can give you a quote.


How did you find out about us.

The completion and transmission of the loan application form creates no commitment on the part of the consultant or lender to extend credit, nor does it commit the borrower to accept any credit which might be extended.  Only a written mortgage, loan or leasing commitment fully executed by the lender and borrower is deemed to be binding.

Borrower hereby confirms that the information provided by the borrower and/or principals, submitted with this loan inquiry as well as any subsequent information, is true and correct and may be relied upon by the consultant and the lender in its consideration of a request to extend credit to the borrower.  .  

 I have read the above and agree.

We will be in touch shortly, and thanks for using 
eloansource.com