RENTAL PURCHASE APPLICATION
PERSONAL INFORMATION
First / Last Name
Social Security #
Date Of Birth
/
Month
/
Day
Year
Date
Primary Address
Your Personal Residence
Please Select
Own
Rent
Live with Relatives
Are You A First Time Home Buyer?
Please Select
Yes
No
How Long At This Address?
Phone
E-Mail
example@example.com
Citizen Status
Please Select
US Citizen
Permanent Resident
Visa Holder
Non US Resident
USA Work Visa Number
Status
Please Select
Single
Married
Credit Score
Yearly Income
Total Cash On Hand to Close Loan
Have you filed for bankruptcy?
Please Select
Yes
No
Date of discharge
Are you using a HELOC or other type of Line of Credit?
Please Select
Yes
No
Have You Had A Foreclosure or Short Sale?
Please Select
Yes
No
Are You Current On All Your Mortgage Accounts?
Please Select
Yes
No
Are you using your pension fund to fund the loan? If so, please specify
SUBJECT PROPERTY INFORMATION
Property Address
Type of Property
Please Select
Single Family Home
2-4 Units
5+ Units
Warrantable Condo
Non-Warrantable Condo
Townhome
Mixed Use
Total Number of Units
If Property Type is Mixed Use, What Percentage of the Property is Residential?
If Property Type is NOT 1-4 Units, Total Number of Units
Is the property MOVE IN Condition?
Type of Rental
Please Select
LongTerm Leased
LongTerm Vacant
ShortTerm Leased
ShortTerm Vacant
Purchase Price
How Long Will You Hold the Property?
Yearly Taxes
Yearly Insurance
Monthly HOA Payment
Rental Income on EACH UNIT
USA (NOT ANOTHER COUNTRY)
Experience That We Can Verify In Your / Your Entity Name
# Fix N Flips Last 36 Months
# Fix n Holds Last 36 Months
# Fix N Flips 5+ Units Last 36 Months
# Fix n Holds 5+ Units In the Last 36 Months
# Fix N Flips Mixed-Use Buildings In the Last 36 Months
# Fix N Flips Mixed-Use Buildings In the Last 36 Months
# of Rentals Owned
BUSINESS INFORMATION
Company Name
EIN #
State of INC
% of Ownership
Date of Incorporation
/
Month
/
Day
Year
Date
If less than 100% ownership, please add all members--name, email address and % of ownership
Applicants Signature
Todays Date
/
Month
/
Day
Year
Date
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