RFG CAPITAL HM APPLICATION

DATE

MonthDayYear
Date
Borrower Name
Current Address
Phone number

Area CodePhone Number
Email address
example@example.com
Co Borrower Name
Co Borrower Phone Number

Area CodePhone Number
Co Borrower Current Address
Co Borrower Address, if different than above
Co Borrower Email address
example@example.com
Subject Property Address, City, State, Zip:
County
State
Property Type:

Other
Select the Loan Type of Interest
Loan Purpose

Other
Lien Position
Length
Estimated Appraised Value
Loan Amount Requested
Desired Funding Date

MonthDayYear
Date
Exit from loan:

Other
Special Inst
*Document Prep & Lender Doc fees are typically collected in a minimum of 24hrs prior to funding Are you able to pay for this amount prior to funding?
Title Company Contact information: Agent Name
Company
Email address
example@example.com
Phone number

Area CodePhone Number
Homeowners Insurance Agent:
Agent Name
Policy Number
Company
Email address
example@example.com
Phone number

Area CodePhone Number
Please indicate in Notes if title insurance is required and any additional conditions that will need to be met for funding
Please tell us who referred you:
Please share any additional comments or context. Our team will be in touch with you promptly:
Should be Empty:

Homeowners Insurance Agent: