Name of Transaction:
Location:
Submitted By:
Phone Number:
Fax Number:
E-Mail:
PROPOSED TRANSACTION INFORMATION:
Nature: i.e. Purchase, Finance, Construction, Real- Estate, or Other
Financing Requested:
Purchase Price (if applicable):
Collateral-Market Value:
Number of Units:
Describe Property and Use:
Describe Purpose of Loan and Use of Funds:
PROPERTY AND/OR BUSINESS INCOME AND EXPENSES:
Annual Operating Expenses: i.e. real estate taxes, water, insurance, fuel, utilities, etc.
Net Operating Income:
Information on Each Applicant:
Social Security Number:
AUTHORIZATION OF CREDIT I/we hereby authorize Kilpatrick & Hart Ltd, Inc. to obtain any reports regarding credit, mortgage payment history, bank accounts or any other information they deem necessary to process our loan request, as well as such additional reports that may require in conjunction with any update, renewal or extension of credit. Anyone receiving a copy or reproduction of my/our names below is authorized to provide the lender of their assigns with such information.
Name:
Telephone Number:
Social Security Number or Tax ID Number:
Home Address:
