Property Type (Check All That Apply) Name Of Borrowing Entity Or Individual(s) Contact Information. Borrowing Entity (Check One) Ownership Breakdown
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1 APPLICATION FORM P.1 Property Name Street Address City, State, Zip Property Type (Check All That Apply) Multifamily Industrial Retail Mixed Use Office Hotels & Motels Other (Describe) Percentage Owner Occupied (If Any) Name Of Borrowing Entity Or Individual(s) Self Storage Health-Related/Senior Living Mobile Home Parks Contact Information Borrower Contact Street Address City, State, Zip Telephone ( ) Fax ( ) Borrowing Entity (Check One) Corporation Trust Partnership Individuals Limited Liability Corporation Other (Describe) primary secondary other Ownership Breakdown Individual/Entity Ownership Percentage Loan Request amount term yrs amortization yrs Purpose Of Loan (Check One) Acquisition Refinance Cash-Out Refinance If an acquisition, what is the purchase price? If a refinance: What was the purchase date? What was the original purchase price? What was the total amount of funds invested during your ownership? Total:
2 APPLICATION FORM P.2 If This Is A Refinance, Is There Existing Debt? (Check One) Yes No If yes, please provide: 1st Mortgage Loan Balance: Lender: Interest Rate: Rate Type: Fixed Adjustable Maturity : 2nd Mortgage Loan Balance: Lender: Interest Rate: Rate Type: Fixed Adjustable Maturity : Does your loan have a prepayment penalty? If so, how much is it? If you are refinancing an SBA loan, is it a 504 or a 7A? 504 7a Complete This Portion For A Multifamily Property Apartments Number of residential units: Number of buildings: Mobile Homes How many spaces? How many homes owned by borrower? Year built: Condition of property: (Check One) Excellent Good Fair Poor Complete This Portion For Commercial Property Square footage: Size of land: Do any of the tenants have an option to buy? If yes, when and for what price? Number of tenants: Year built: Yes No Property type: Condition of property:(check One) Annual Operating Expenses Real estate taxes: Insurance: Management expenses: Other operating expenses: What Do You Estimate The Value To Be? Excellent Good Fair Repairs and maintenance: Reserves for replacements: Utilities: Poor Please include the following with this application: Copies of all leases, appraisals, and environmental reports (if any). If building is proposed, include copy of plans, specifications, cost breakdown, and site plan. Photos of subject property (digital or prints). Signature of Primary Borrower or Contact Person
3 APPLICATION FORM P.3 CONFIDENTIAL FINANCIAL STATEMENT AS OF: Applicant s Name (Last) (First) (Middle Init.) Social Security Number Bus TIN Address City State Zip Married Separated Unmarried Other name(s) of applicant in which credit has been granted or in which Social Security or Tax ID No. references may be verified Spouse s Name (Last) (First) (Middle Init.) Social Security Number Cash on hand Cash in Bank Cash in Bank Cash in Bank U.S. Government Bonds Stocks and bonds:, Cash value of life insurance Accounts and notes receivable Monthly Real esate owned: Income Mortgage and Contracts owned Automobiles: address make yr make yr Trucks Household & personal property Other assets ATTACH SCHEDULES IF SPACE IS INADEQUATE ASSETS LIABILITIES Accounts payable (not installment) Monthly Installment accounts Payment (Item) (Creditor) Notes per Accrued taxes payable Life insurance loans Monthly Payment Mortgages on real estate (Mortgagee) (Mortgagee) Other Debts Total Assets Sources of Annual Income Salary before deductions Overtime, bonus or commissions Professional income, net Spouse s salary before deductions Real estate income, net Dividends, annuities, etc. Other income Total Annual Income Total Liabilities Net Worth Total Liabilities & Net Worth Contingent Liabilities or others not Included Above Are any assets pledged? Are presently being sued? Have you ever taken bankruptcy? Applicant s Signature Phones: Residence Co-Applicant s Signature Business 09/03/03
4 APPLICATION FORM P.4 COMMERCIAL INCOME & EXPENSE HISTORY Borrower: Property Address: Sources of Income: Year to Last Year: Prior Year: F rom: to: F rom: to: F rom: to: R E NTS CAM Other (Specify) Other (Specify) Total Income Collected: Expenses: Real Estate Taxes Fire Insurance Water Sewer Electricity Gas Trash Cable TV Security Services Accounting Off-site Management Salaries Security Services Pay-roll Taxes Office Expenses Tenant Improvements Maintenance/Repair Landscaping Maintenance Contracts Capital Improvements Business License Legal Fees Advertising Commissions Miscellaneous Other - Telephone Total Expenses: Net Operating Income: I certify under penalty of perjury that the information herein is true and correct as of:. Signature Seller's Signature
5 Retail Total Percentage Rent Sales Percentage Rent Sales Break Point Toll Free: APPLICATION FORM P.5 Commercial Property Rent Roll Property Address: Borrower/Applicant: Lessee Unit # Leased NRSF Total Market/ Annual Rent Leased Rent/ NRSF Type (G. MG. NNN) CAM Reimbursement Comments Original Lease Beg. Lease Beg. Lease End CCB-104-(Rev. 03/03) Perc. Rent Percentage Total NRSF /NRSF Actual Leased COPIES OF ALL LEASES AND TENANT ESTOPPELS ARE REQUIRED. Actual Vacant Gross Potential Income I certify under the penalty of perjury that the information herein is true and correct as of. D ate A pplicant Seller
6 Fax 2 APPLICATION FORM P.6 Multifamily Rent Roll Property Street Address: City: State: Zip: Borrower/Applicant: # Vacant Units: # Furnished Units: # Unfurnished Units: # Section 8 Units: Apt. # Tenant s Name: Bed. / Bath Sq. Feet (approx.) Rent in Place Original Occup. Lease Expiration (or MTM) Last Rent Increase Furnished Unit (Y/N) Sec. 8 (Y/N) Any Rent Concessions? All columns and sections must be completed. Monthly Rent Schedule: What utilities are included in rent? Monthly Laundry Income: Monthly Garage Income: Is the property subject to rent control? Other: (specify) Total Gross Monthly Income Gas Electricity Cable TV Water Heat Garbage Yes No If YES, what is the current allowable increase per year? What has been your average monthly occupancy rate over the preceeding 12 months? I certify under the penalty of perjury that the information herein is true and correct as of (date). Borrower/Seller Borrower/Seller CCB-104-(Rev. 04/04)
7 name Schedule of Real Estate Owned (Schedule 5) (Show Percentage of Ownership Only) Cash Flow (column 1 less columns 2&3) (3) Annual Payments (exclude impounds) (2) Total Operating Expenses (include taxes & ins.) (1) Effective Gross Income Remaining Balance of Mortgage Name of Lender Loan # Maturity Present Market Value Acquisition Cost Acquis. Property Type/ # of Units (100) Owned Property Address Totals: Toll Free: APPLICATION FORM P.8 This addendum is incorporated into and shall be deemed to amend and supplement the Financial Statement to which it is attached. This schedule must be completed in its entirety. Any/all attachments must be signed, dated and include the information shown below. signature signature CCB-102C-( Rev. 3/03)
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