Personal Information

Contact Person:

Borrower/Applicant  Broker  Other:
*

Email:

*

Phone:

*

Fax:

Project:
(For easy identification please insert a title for your project.  Example: "Sunset Apartments" or "Rainbow Motel".)

*

Project Information

Property Address:

2nd line of address:

City:

*

State:

*    Zip:

Type of Property

* Apartment Assisted Living Auto Repair Auto Dealership Bed and Breakfast Inns Casino Church Commercial or Retail Congregate Care Facility Gas Station Golf Course Hotel-Motel Industrial Buildings Land Medical Building Mini-Warehouses Mixed Use Mobile Home Park Multi-Family 5+ units Office Building Restaurants Shopping Centers Special Use Properties

Number of Buildings:

Number of Units:

Number of Floors:

Land Area:

Building Area:
(Gross)

Building Area:
(Net)

Number of Parking Spaces:

Construction Costs

Hard and Soft Costs:
(excluding land)

Value of Land:

Date Land was Purchased:

Amount Paid:

Purchase Price of Land:
(if loan includes land purchase)

Prepaid Construction Costs

Land:

Demolition:

Plans:

Engineering:

Permits:

Grading:

Other:

Requested Amount of Construction Loan:

Borrower Information

Type of Entity:

   Individual Corporation General Partnership Limited Partnership Limited Liabality Company Other

Net Worth:

   $100,000 to $250,000 $250,000 to $500,000 $500,000 to $1,000,000 $1,000,000 to $2,000,000 $2,000,000 to $5,000,000 $4,000,000 to $6,000,000 6,000,000 and up

Name of Borrower 1:

Name of Borrower 2:

Name of Borrower 3:

Name of Borrower 4:

Phone:

Fax:

Email: