Broker InformationBorrower Information
Your Name (required)Borrower Name (required)
Your CompanyCo-Borrower
Your Phone (required)Borrower Phone (required)
Your Email (required)Borrower Email (required)
Approximate Credit Score  
Loan InformationProperty Information
Current Market Value of PropertyProperty Street Address
Loan Amount RequestedCity
Lien PositionCalifornia, Zip
Loan To Value/CLTVCounty
Loan Term (60 days to 5 years)Amount owed on Subject Property
Loan Program – Investor, Rehab or BusinessIf Refinance, Date property was purchased
Property TypeOriginal Purchase Price
Occupancy – O/O, NOO:O/ONOOAppraised Value
  Date of Appraisal
Purchase InformationCash Out Refinance
Purchase PriceAmount of Cash Out
Underwriter Information
Reason Why borrower does not qualify for a conventional loan

Ability to Pay
Borrower IncomeOther Income
Co-Borrower IncomeOther
Loan Exit Strategy
Sale of PropertyYesNo
Target Sales TimeframeTarget Sales Price/After Repair Value
Has loan been submitted elsewhere for approval?Status or Outcome?