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Property Name
Property City & State	AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NM NV NY OH OK PA RI SC SD TN TX UT VA VI VT WA WI WV WY
Loan Amount	-Select One- $400,000 to $1 milliion $1 milliion to $2 milliion $2 million to $3 million $3 million to $8 million $8 million to $20 million $20 million to $100 million+
Apx. Loan to Value	-Select One- Less than 50% 50% to 60% 60% to 70% 70% to 80% 80% or more
Property Type	-Select One- Multi-Family Retail Strip Center Credit Tenant Lease Owner Occupied Industrial Office Self-Storage Hotel/Motel Assisted Living Manufactured Housing Restaurant Church Gas Station Raw Land Other
Type of Loan	-Select One- Permanent Short Term/Interim Construction Rehab Mezzanine Other
Reason for Loan	-Select One- Acquisition Loan - Under Contract Acquisition Loan - No Contract Refinance Loan Construction Loan Other
Applicant Name
Affiliation	Principal     Broker
Phone	Ext.
Fax
E-mail Address
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