Your Contact (Full Name):*	Important Item
Your Contact (Email Address):*	Important Item
Your Contact (Phone Numbers):*	Important Item
Your Contact (City, State and Zip Code):*	Important Item
You Are a:*	Borrower. Broker
Type:*	First Mortgage Construction Loan Bridge Loan Mezzanine Loan - Standing Property (Purchase or Cash out) Mezzanine Loan - New Construction or Major Rehab Second Mortgage   Important Item Check here if you want an SBA loan. (Must be 50% owner used.) I need a bridge loan (very fast, short term, more expensive loan). This loan probably requires a hard money lender (more expensive but lenient).
Amount of Loan Request:*	(Do not use cents or decimals)  Important Item
Sales Price/Value of the Collateral:*	(Do not use cents or decimals)  Important Item
Amount of the Down Payment:	(if applicable and do not use cents or decimals)
Property Address:*
2nd line of address:
City:*	State:      Zip code:  (If applicable)
Country:*
Type of Property:*	Agricultural or Ranch Property Apartment Building / Multifamily Dwelling Assisted Living Facility Auto Dealership/Used Car Lot Auto Repair Bed & Breakfast Inn Bowling Alley C-Store Casino Church Commercial or Retail Building Congregate Care Facility Convalescent Hospital Cooperative Duplex, Triplex, or Fourplex Gas Station Gentlemen's Club Golf Course Hotel & Motel Industrial Building Industrial Condo Land Marina Mixed Use Property Mobile Home Park Movie Theater Office Building Office Condo Other Parking Garage Please Choose Residential Care Home Residential Condo Residential Condo Subdivision Residential Subdivision Restaurant Self Storage Shopping/Strip Center Single Family Residence Skilled Nursing Facility Special Use Property
Other-Explain:
Gross Rentable Area:	(square feet)
Net Rentable Area:	(square feet)
Number of Units:
Number of Vacancies:	(if known)
Vacancy Rate for the Area:	1 2 3 4 5 6 7 8 9 10 11 12 15 20 25 30 35 40 45 50 55 60 %
Description of the Building(s):
Age of the Building(s):	years  Last Renovated:  Years ago
Purpose of the Loan:	Purchase Maturing loan (no cash out) Maturing loan (cash out) Cash-out Refinance Rate and term refinance (no cash out) New Construction Renovate or Expand the Property Some Renovation and Some Cash Out Other
Interest Rate Desired:	4 4.125 4.25 4.375 4.5 4.625 4.75 4.875 5 5.125 5.25 5.375 5.5 5.625 5.75 5.875 6 6.125 6.25 6.375 6.5 6.625 6.75 6.875 7 7.125 7.25 7.375 7.5 7.625 7.75 7.875 8 8.125 8.25 8.375 8.5 8.625 8.75 8.875 9 9.125 9.25 9.375 9.5 9.625 9.75 9.875 10 10.125 10.25 10.375 10.5 10.625 10.75 10.875 11 11.125 11.25 11.375 11.5 11.625 11.75 11.875 12 12.125 12.25 12.375 12.5 12.625 12.75 12.875 13 13.125 13.25 13.375 13.5 13.625 13.75 13.875 14 14.125 14.25 14.375 14.5 14.625 14.75 14.875 15 15.125 15.25 15.375 15.5 15.625 15.75 15.875 %
Loan Fee:	point(s) to the lender and  point(s) to the broker
Amortization Schedule Desired:	15 20 25 30  years
Loan Term Desired:	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30  year(s)
Special Issues, Problems, or Needs:| (you may state your loan scenario here.) Input senior loan info if you're seeking a second mortgage.
Curb Appeal:	Please Choose 1 - Run Down Old Building in Low Income Area 2 - Average Building in a Low Income Area 3 - Well Maintained Building in a Low Income Area 4 - Older Building in a Middle Income Area 5 - Average Building in a Blue Collar, Middle Income Area 6 - Average Building in a White Collar, Middle Income Area 7 - Well Maintained Building in Upper-Middle-Income Area 8 - Brand New Building in Average Neighborhood 9 - Brand New Building in Upper-Middle-Class Area 10 - Brand New Building on the Richest Street in Region 11 - I Don't Know

Borrower Information                                                 

1. Borrower 1
   

   Name of Borrowers/Couple:*
   Type of Entity:	Individuals Corporation General Partnership Limited Partnership Limited Liability Company Other
   Occupation:
   Annual Income:*
   Net Worth:	less than $250,000 $250,000 to $500,000 $500,000 to $1,000,000 $1,000,000 to $2,000,000 $2,000,000 to $5,000,000 $5,000,000 to $10,000,000 more than $10,000,000
   Credit:	I Don't Know Perfect Very Good Good Decent Reestablished after bankruptcy Slow pay Poor Bankruptcy discharged within 3 years In Chapter 11 Bankruptcy In Chapter 7 Bankruptcy
   Credit Score (if known):	(3 digits)

2. Borrower 2
   

   Name of Borrowers/Couple:*
   Type of Entity:	Individuals Corporation General Partnership Limited Partnership Limited Liability Company Other
   Occupation:
   Annual Income:*
   Net Worth:	less than $250,000 $250,000 to $500,000 $500,000 to $1,000,000 $1,000,000 to $2,000,000 $2,000,000 to $5,000,000 $5,000,000 to $10,000,000 more than $10,000,000
   Credit:	I Don't Know Perfect Very Good Good Decent Reestablished after bankruptcy Slow pay Poor Bankruptcy discharged within 3 years In Chapter 11 Bankruptcy In Chapter 7 Bankruptcy
   Credit Score (if known):	(3 digits)

Check here if you have additional borrowers to be listed.

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Property Income

Gross Scheduled Income:		* (annual)
* Include the market rent of any vacant units and any owner-used units
Other Income (laundry, parking, etc.):		(annual)

Expenses                                                    

Real Estate Taxes:	$  (current actual)
Insurance:	$  (current actual)
Management Expenses:	$  (annual)
Repairs and Maintenance:	$  (last year actual)
Reserves for Replacement:	$  (annual)
Utilities:	$  (last year actual)
Other Operating Expenses:	$  (annual)
BROKER'S RELATIONSHIP TO BORROWER The borrower is a first time customer. I have closed a loan for this borrower before. The borrower is a relative or a personal friend. I have unusual control over the deal. I have not yet received a loan package from the borrower. I have a partial package on the deal. I have a full package on the deal. I am dealing directly with the borrower. I am dealing through another broker or party. I do not have a signed contract with the borrower. I have a signed contract with the borrower. I am relatively new to commercial mortgage finance. I have some experience brokering commercial loans. I have been brokering commercial loans for many years.     *By submitting this form, you are consenting to receive email and telephone calls from Preferred Mortgage. Your information will not be provided to any other third parties and will be protected subject to our privacy policy.

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