(404) 634.4700
Borrower:
Subject Address:
City:
State: ---AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyoming
Country:
Zip Code:
Purchase Price (if purchased):
Year Purchased (if purchased):
Porperty Value:
Loan Amount Requested:
Purpose of Loan: ---PurchaseRefinanceOther
Property Type: ---OfficeRetailLight IndustrialMulti FamilySpecial PurposeOther
Contact Person:
Company:
Telephone:
Email:
Fax:
Please type the code in the box below