LOAN TYPE*
Investment Purpose Only (Non-Owner Occupied)Primary Residence (AZ and CA Only)
LOAN PURPOSE*
PurchaseRefinance, Cash OutRefinance, Rate/TermRefinance, Plus Rehab Draws
[group t5 clear_on_hide] CURRENT AMOUNT OWED ON PROPERTY*
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[group t6 clear_on_hide] WILL CASH-OUT FUNDS BE USED TO REHAB/REPAIR THE PROPERTY?*
YesNo[/group]
LOAN PAYOFF/ EXIT STRATEGY**
Sale of PropertyRefinanceOther
[group t4 clear_on_hide] WHAT IS THE OTHER PAYOFF STRATEGY?
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CLOSE DATE REQUESTED

LOAN AMOUNT FOR REHAB

PROPERTY AFTER-REPAIR VALUE*

PROPERTY PURCHASE DATE

PROPERTY TYPE*
Single Family ResidenceCondominium2-4 Units5+ Units ApartmentsMixed Use
[group t1 clear_on_hide] TOTAL NUMBER OF UNITS*
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[group t2 clear_on_hide] SQUARE FOOTAGE PER RESIDENTIAL UNITS*

GROSS ANNUAL RENTS*
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PROPERTY ADDRESS*

Street Address

Address Line 2

City

State*
AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandPennsylvaniaSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific
Zip Code

PROPERTY AS-IS VALUE*

BORROWING ENTITY NAME*

SIGNATORY/GUARANTOR FIRST NAME*

SIGNATORY/GUARANTOR LAST NAME*

BORROWER PRIMARY CONTACT PHONE*

BORROWER PRIMARY CONTACT EMAIL*

SIGNATORY/GUARANTOR CREDIT SCORE*
Above 700Between 675 and 700Between 650 and 675Between 625 and 650Between 600 and 625Between 575 and 600Below 575
NUMBER OF INVESTMENT PROPERTIES SOLD OR REFINANCED IN THE LAST 3 YEARS*

SIGNATORY/GUARANTOR IS U.S. CITIZEN OR PERMANENT RESIDENT*
YESNO
ARE YOU THE BORROWER OR THE BROKER FILLING OUT THIS FORM?*
BorrowerBroker
[group t3 clear_on_hide]NATIONAL CAPITAL CONTACT PERSON*
Beaux JohnsonNathan Johnson
BROKER COMPANY NAME*

BROKER PRIMARY CONTACT FIRST NAME*

BROKER PRIMARY CONTACT LAST NAME*

BROKER PRIMARY CONTACT EMAIL*

BROKER PRIMARY CONTACT PHONE*

BROKER ORIGINATION POINTS (PERCENT FORMAT)*
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TERMS OF USE*
I agree with NATIONAL CAPITAL Terms of Use and Privacy Policy
ANYTHING ELSE WE SHOULD KNOW TO PROVIDE THE BEST SERVICE/QUOTE TO YOU?

HOW DID YOU HEAR ABOUT NATIONAL CAPITAL?*

*please fill out all required fields