Name of Borrower

Full Property Address:

Liquid Assets:

Credit Score:

Citizenship Status:

# of New Builds in Past 3 Years:

Vacant Lot or Tear down & Rebuild:

Purchase or Lot Owned:

Purchase Date if Owned:

Lot Payoff if Owned:

Lot Current As-is Value:

Lot Purchase Price:

Construction Costs:

After Completed Value:

Anything else I should know about this deal?