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Personal Information

* First Name:
* Last Name:
* E-Mail:
* Phone Number:  -  - 
Company Name:
Street Address:
Zip Code:
Work Phone:  -  - 
Fax:  -  - 
Loan Information

Loan Type:
Amount of Loan Request:
Sales Price/Value of the Collateral:
Amount of Down Payment:
Property Address:
Property Address (Cont):
Property Zip Code:
Type of Property:
Gross Rentable Area:   sq. ft.
Net Rentable Area:   sq. ft.
Number of Units:
Number of Vacancies:
Age of Building:    yrs.
Purpose of Loan:
Interest Rate Desired:
Loan Fee: point(s) to the lender
Points to Broker:
Amortization Schedule Desired:
Loan Term Desired:

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