Section 1
First Name
Last Name
Phone Number
Email Address
Company
Section 2
First Name
Last Name
Phone Number
Email Address
Section 3
Property Type
Multi-Family
Mixed-Use Tier 1 (Primarily Res)
Mixed-Use Tier 2 (Primarily Comm)
Office
Retail/Wholesale Store/Strip Center
Warehouse
Self-Storage Facility
Light Industrial
Mobile Home Park
Automotive
Bulk Multiple-Residential Condo
Bulk Multiple-Residential 1-4
Commercial Condo
Restaurant/Bar
Day Care
Single Family
2 To 4 Family
Residential Condo
Other
PUD
Town House/Row House
Investor Fix & Flip
Loan Purpose
Purchase
Refinance
Cash Out
State
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Loan Amount
Comments
Comments