Your name: Phone: Email: Position with company: Select Owner/CEO/President Attorney COO CPA Manager/Office Manager Partner Secretary Treasurer Vice President Other Company name (Borrower): State: Loan amount Type of financing? Select Bridge financing Conventional loan FHA Commercial FNMA commercial Freddie Mac Commercial HUD commercial Hard money Factoring (construction) Factoring (healthcare) Other If other, please indicate: Are you seeking? Select Acquisition Construction (New) Construction (Rehab) Refinancing Factoring (construction) Factoring (healthcare) Other Property type: Select Assisted living facility Apartment building-Multifamily Carwash Condo-co-ops C-Store Gas station Golf course Healthcare/medical facility Hospital Hotel (Flagged) Hotel (Independent) Industrial Land (commercial) Mixed use Nursing home Office building Parking garage/lot Restaurant Retail center Self-storage Warehouse Other If other, please indicate: How many lenders have seen this deal? Deal Summary | Specific Funding Requirement (if any):