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LOAN QUESTIONNAIRE:

Loan Amount Requested*
Purpose:
Term Requested:
Amortization Requested:
Rate Requested:
Summary:
Property Info:
Project Name
Occupancy:
Property Type:
Property Value
Date Purchased:
MM
DD
YYYY
Purchase Price:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Annual Income:
Annual Expenses:
Size (SF):
Borrower Info:
Borrower Name
First Last
Company Name:
Phone
Bankruptcy:
Submitted By:
Name*
First Last
Submission Company:
Email*
Submission Phone*
Submitted By: