Broker Loan Submission Loan Amount Requested $ Loan Purpose * Property Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Property Type * Residential Commercial Land/Lot Other Property Value * $ Purchase Price * $ Original Date Purchased * MM DD YYYY Original Purchase Price * $ Loan Amount Requested * Mortgage Balance * Property Taxes & Insurance Costs * Borrowers(s) Credit Score * Guarantor(s) Name * Business Name * We will get back you shortly and let’s see if we can do a deal.