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Funding Request
Principal Name
Borrowing Entity (if different)
Entity Type
Company
Corporation
Investor
Partnership
Non-Profit
Name
*
First
Last
Email
*
Office Phone
*
Mobile Phone
City
State
Current Loan Value
Present Loan Status
Current
Delinquent
In Default
Foreclosure Action
Total Project/Acquisition Cost
Amount of Funding Needed
Type of Property or Asset
Receivables
Inventory
Equipment
Real Estate
Other
Estimated Market Value
Reason for Request
Acquisition
Refinance
Construction
Renovation
Other
If Refinance, is existing loan current?
Yes
No
How did you hear about us?
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Email
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