Financing Request Form

For Real Estate Investing Financing Only. Not for Primary Residence loans (ie. property borrower resides or intends to reside).

Complete all fields applicable to your situation and try to be as accurate as possible. Fill in your Agent's Name and Rep ID. If you are not currently working with an Agent (Rep), please email our office for instructions before completing this form.. Email us at

Agent (Rep) ID*

Agent Name:*

Transaction Type:*

Property Type: *

If Purchase:
Purchase Price

Estimated Value of Property

Down Payment Amount

Is property being Rehabbed?

If yes, approximate rehab costs?

Estimated After-Repair-Value (ARV)?

For Refinance:
Estimated Value of Property

1st Mortgage Balance

2nd Mortgage Balance (if applicable)

Any other liens against property?

If yes, approximate total balance owing on all liens outside of 1st and 2nd mortgages.

Is this a cash-out refinance?

If yes, amount of cash out desired?

Are any funds from cash out being used to rehab property?

If yes, approximate rehab costs?

Estimated After-Repair-Value (ARV)?

Property Address:

Street (Unit numbers)




Borrow Info:
Full Name*

Contact Phone*

Email Address*

Mailing Address*

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