1300 4th St, San Rafael, CA 94901
(844) 625-4280
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– Broker Information
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Referring Broker Company Name
*
Contact Person
*
Phone
*
Email
*
Address
Street Address
City
State
Zip Code
Description
Include Number of Units and Unit Breakdown (Commercial, Retail, Office, Residential, Warehouse, Hospitality, Land or Other) If Construction # of Units to be built
Purchase or Refinance
Purchase
Refinance
For purchase, list Price:
For Purchase, is there an executed PSA:
For Purchase, when is the closing date:
MM slash DD slash YYYY
For refinance, list original purchase price:
For refinance, list original purchase date:
MM slash DD slash YYYY
For Refinance, list current debt:
For Refinance, list current lender:
For Refinance, is loan current or in arrears
Loan
Arrears
For Refinance, list any liens or judgements:
For Refinance, is the loan in Forbearance:
Yes
No
Is this a Primary Residence (Yes or No):
Yes
No
Anticipated Current Value:
Gross Income:
Operating Expenses:
Net Operating Income:
Provide Budget:
Provide ARV or Completed Value:
Loan Amount:
LTV:
Loan Term:
Anticipated Rate:
Explain any Cash Out Requested:
Total Broker Points:
Entity Name:
*
Guarantor Name:
*
Home Address
Street Address
City
State
Zip Code
Phone
*
Email
*
Credit Score:
*
Experienced (Yes or No):
*
Yes
No
