Lender/Investor's Disbursement Setup Form

Lender/Investor's Disbursement Setup Form
LENDER’S INFORMATION:
Lender Name
Contact Name
Address

Address

Street Address Line 2

CityState

Zip
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Cellphone Number
Please enter a valid phone number.Format: (000) 000-0000.
Fax
Please enter a valid phone number.Format: (000) 000-0000.
E-mail
example@example.com
TIN/EIN
LENDER’S BANK INFORMATION FOR CASH FLOW / DIRECT DEPOSIT:
Name of Bank
Type of Account
Bank Address
Name on Account
Routing Number
Account Number
NOTE: AUGUST REI, LLC WILL ONLY ADMINSTRATE CHECKS PER THE DIRECTION OF THE LENDER. IF APPLICABLE, AUGUST REI, LLC WILL NOT PREFORM ANY INSPECTION FOR QUALITY OF WORK ON THE PROPERTY.
Special Notes/Instructions from Lender to August REI, LLC:
Please write in this box the effective date of transfer and any special instructions
The information provided herein and accompanying documentation are true and correct to the best of my knowledge.
Lender’s Signature
Lender’s Printed name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: