Before completing this application we ask four questions:

1) Loans must he secured by Real Estate. Is the loan requested to be secured by Real Estate?
2) We lend only in California. Is the Real Estate located in California?
3) Minimum Loan = $30,000. Is your loan request for a minimum of $30,000?
4) We require reasonable ability to pay. Do you have reasonable ability to make payments?

If you’ve answered “YES” to all four questions, please continue!

BORROWER

First Name (Required):	Last Name (Required):
Phone # (Day):	Phone # (Evening):
Email Address (Required):	Preferred Method Of Contact:
SUBJECT PROPERTY - CALIFORNIA ONLY
All Loans Must Be Secured By Real Estate
Address: (Required)	City: (Required)
State: (Required)	Zip Code:
Property Type:	Property Description:
NEW PURCHASE
Purchase Price $:	Down Payment $:
REFINANCE
Date Purchased:	Purchase Price$:
Estimated Value $:	Per Recent Appraisal ?
EXISTING LOANS
1ST Loan Balance = $	2ND Loan Balance = $
3rd Loan Balance = $	Additional Liens = $
LOAN REQUEST
Minimum Loan = $30,000
Loan Amount Requested: (Required)	New Loan Position:
Purpose of Loan (How Funds Will Be Used) :	Comments:
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