Loan Questionnaire
Carolyn Coke 561-800-8206
Todays Date
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Month
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Day
Year
Date
Name of Applicant
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First Name
Last Name
E-mail
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Phone number
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Area Code
Phone Number
Business Name (If Applicable)
Industry of Business
Years in Business
Monthly Revenue Sales
Provide a brief description of your loan scenario or any additional info we should know:
Address of Subject Property or Business
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What type of loan are you looking for?
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1-4 Unit Investment Properties
Multi-Family
Fix and Flip
SBA
Hard Money
New Construction
Land Only Purchase - New Construction
Foreign National
Equipment Financing
Business Working Capital
Business Line of Credit
A/R Factoring
What's Your Fico Score
Please Select
500-550
551-601
602-850
Loan Amount Request
Citizenship
*
US Citizen
ITIN
PRA
Other
How many flips or rehabs have you completed in the last 3 years?
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Do you have any possible tax liens, bankruptcy, or foreclosure in last 24 months?
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Please Select
Yes
No
Submit my application
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