E-Z Hard Money - Loan Submission Form
Broker Information
Company Name
Loan Officer Name
Loan Officer Phone
Loan Officer Fax
Loan Officer Email
Borrower Information
Full Name
First
M.I.
Last
Address
Street Address
City
State
Zip
Phone:
Email Address:
Credit Score
Credit Score
Credit Score
Loan Information
Monthly Payment
Balance
1st Mortgage
2nd Mortgage
Is the borrower behind on any mortgage payments?
-- select one --
Yes
No
-- - Amount
Are there any other unknown liens on title?
-- select one --
Yes
No
-- - Amount
Is there any cash out amount requested?
-- select one --
Yes
No
-- - Amount
Appraised Value of Property:
Date of Appraisal (mm/yy)
Loan Amount Requested:
Needed by (mm/yy)
LTV/CLTV:
%
Reason for Loan?
Is there anything else we should know?
