Apply : 123 Fund It | Robert Conrad 214-803-4650

Borrower Information

Borrower Name or Company Name*

First Last

Borrower's Email*

Broker Email*

Borrower's Phone*

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Business name (if applicable)

Borrower's Current Address**

Street Address Address Line 2 City State ZIP Code

Will there be a Co-Borrower

Exit Strategy*

Other properties available to include as collateral*

Purchase Price*

Rehab Budget Amount*

Estimated Value As-Is

Estimated Value After Repair

Subject Property Address**

Any Additional Information or Comments

Were You Referred To Us By Someone or a Website?

Who Referred You To Us?

Executed Contract Or Other docs (If Refi- please upload survey, appraisal, lease , pics etc..etc..)*

Drop files here or

Executed Contract Or Other docs (If Refi- please upload survey, appraisal, lease , pics etc..etc..)

What loan amount are you requesting?*

Total amount of Hard money loans outstanding?*

Ever Declared Bankruptcy?*

Been Foreclosed On?*

Had a Judgment Levied?*

Available Cash / Cash on Hand*

# of Investment Properties Currently Owned*

# of Flips in Past 12 Mo.*

Any outstanding loans/liens on subject property ?

Any credits or concessions being given to borrower ?*

Are you planning on owner financing the home or placing any kind of 2nd lien?*

Is there any fire, flooding, or tornado damage to the property, or any other major damage?*

Is there any assignment or double close involved?*

Closing date*

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