Broker Submission Borrow Name * First Name Last Name Borrower Email * Borrower Phone (###) ### #### Borrowing Entity * Property Address Address 1 Address 2 City State/Province Zip/Postal Code Country Loan Type Purchase Refinance Occupancy Type 12 Month Leases Short Term Rental Vacant / Month to Month Property Type 1-4 Family 5+ Mixed-Use Number of Units Monthly Rental Income Yearly Taxes Estimated Yearly Insurance Purchase Date (If Refinance) MM DD YYYY Purchase Price (If Refinance) Estimated FICO Approximate As-Is Value LTV Requested (%) Anticipated Close Date MM DD YYYY Current Loan Balance Bankruptcies/ Foreclosures/ Short Sale Date (if applicable) MM DD YYYY Interest Rate Expectations (%) Broker Name First Name Last Name Broker Phone Number (###) ### #### Broker Email Thank you! We will be in touch shortly! Feel free to call us at the number above.
