FULL NAME
RESIDENCE ADDRESS
EMAIL ADDRESS Email
PREFERRED PHONE NUMBER
CASH ON HAND AND IN BANKS $
SALARY FROM EMPLOYMENT $
NET INVESTMENT INCOME $
REAL ESTATE INCOME
OTHER INCOME AND/ OR PERSONAL ASSETS $
SELF EMPLOYED? yes no
NAME OF EMPLOYER AND/ OR ENTITY
POSITION/ TITLE
EIN (IF KNOWN AND/ OR AVAILABLE)
TYPE OF BUSINESS
TYPE OF BUSINESS INDIVIDUAL PARTNERSHIP CORPORATION LLC OTHER
YEARS ON THIS JOB
YEARS EMPLOYED IN THIS LINE OF WORK/ PROFESSION
BUSINESS PHONE NUMBER
SUBJECT PROPERTY ADDRESS
PROPERTY TYPE SINGLE FAMILY 2-3 MULTI-FAMILY 4 AND UP MULTI-FAMILY MIXED USE OTHER
PROPERTY TYPE PURCHASE PURCHASE/ REHAB CASH OUT REFINANCE NEW CONSTRUCTION REHAB ONLY
PURCHASE PRICE $
ESTIMATED REHAB COST $
ESTIMATED AFTER REPAIR VALUE $
TOTAL ESTIMATED CURRENT MARKET VALUE OF ALL REAL ESTATE OWNED $
TYPE OF PROPERTY
ADDRESS OF PROPERTY
DATE PURCHASED
ORIGINAL COST
PRESENT MARKET VALUE
MORTGAGE BALANCE, IF APPLICABLE
I AUTHORIZE EASY CAPITAL GROUP TO MAKE INQUIRIES AS NECESSARY TO VERIFY THE ACCURACY OF THE STATEMENTS MADE AND TO DETERMINE CREDITWORTHINESS.
I CERTIFY THAT THE ABOVE AND STATEMENTS CONTAINED HEREIN ARE TRUE AND ACCURATE AS OF THE STATED DATE.
I UNDERSTAND THAT THESE STATEMENTS ARE MADE FOR THE PURPOSE OF EITHER OBTAINING A LOAN OR GUARANTEEING A LOAN.
SIGNATURE (TYPE YOUR FULL NAME)
DATE OF APPLICATION
DATE OF BIRTH
SOCIAL SECURITY NUMBER
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