Loan Referral Form

Please fill out the online referral form as completely as possible. Although every field is not required for you to receive a referral fee from us at funding, the more information we have to start the process, the more likely we are to establish a successful relationship with the borrower.

You will automatically receive a copy of your submission when you hit submit.

Earn Referral Fees

Referral Partner's Information

Name *

First

Last *

Last

Email *

Phone:

Business Name:

Address:

Address 2:

How did you hear about us? :

I am a ... Realtor Loan Broker Other

May we say who referred us?:

Borrower's Contact Information

First Name

Last Name

Email:

Phone Number:

Loan Purpose * Purchase Only Acquisition/Rehab Cash-Out Refinance

Property Address

Property City

Property State

Property Zip Code

Property Use - Please Describe *

Property Type Single Family Residence Townhouse Condo Multi-Family (2-4 units) Apartment Building (>4 units) Office Building Shopping Center/Retail Bar/Restaurant Industrial Other

Requested Loan Amount: $

Purchased Price (if purchased): $

Estimated Current Value of Property: $

Estimated Value of Property After Rehab (if applicable) : $

Estimated Repair Costs (if applicable): $

Do you own any other properties?: Yes, and I have equity in them Yes, and I have no equity in them No, this will be my first time

What is your exit strategy? (How do you plan to repay this loan?): Sell property Refinance this property with a bank Payoff with cash Payoff through other business

Additional Comments/Questions:

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Thank you in advance for all your referrals.