RE Funding - Client Intake Form

Client Intake Form

Please fill out the following information to help us understand your property and financial details.
- Name
  
  First NameLast Name
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Email
  example@example.com
- Date of Birth
  
  MonthDayYear
  Date
- Personal Credit Score
- Primary Address
  
  Street Address
  
  Street Address Line 2
  CityState / ProvincePostal / Zip Code
- Business Name
- Position/Title
- Business Website (if applicable)
- Loan Type
- Loan Amount Requested
- Property Type
  
  Other
- Loan Type
- If Other, Specify
- Property Address
  
  Street Address
  
  Street Address Line 2
  CityState / ProvincePostal / Zip Code
- When was the property purchased, if applicable?
  
  MonthDayYear
  Date
- Purchase Price, if applicable
- Current Property Value, if applicable
- Payoff Amount, if applicable
- Rental Income Amount, if applicable
- Rehab/Build Budget, if applicable
- Annual Insurance, if applicable
- ARV (After Repair Value), if applicable
- Annual Taxes, if applicable
- Do you own the land?
- Are you under contract?
- Is the property occupied?
- Do you have plans and permits, if applicable?
- How much do you have for down payment?
- How many properties have you renovated in the last 36 months?
- How many rental properties do you own?
- How did you find us?
- Upload any documents, photos, etc. you would like to share with us.
  
  Cancelof
- Broker Name
- Broker Phone Number
- Broker Email Address
- Sign here to give us permission to contact you.
- Should be Empty: