Connected Capital

Quick Loan Intake Form

Please complete this intake as accurately as possible. This information may be used to prepare lender-facing application materials, structure a preliminary term sheet, and begin pipeline tracking.

If a field does not apply, enter N/A.

1. Submission Information

Who is completing this intake?

Date Submitted

Broker / Referral Name

Broker / Referral Email

Broker / Referral Phone

2. Borrower / Guarantor Information

Full Legal Name

Date of Birth

Social Security Number or Last 4

Primary Phone

Email Address

Expected Credit Score

Marital Status

If Married or Separated, Spouse Name

3. Home / Mailing Address

Current Home Address

City

State

ZIP

Own or Rent

Years at Residence

Mailing Address Same as Home?

Mailing Address (if different)

Mailing City

Mailing State

Mailing ZIP

4. Borrowing Entity Information

Borrowing Entity Name

Entity Type

State of Organization

Tax ID / EIN

Are you the majority owner?

Title-Holding Name (if different)

Reserves Verification Acknowledged?

Entity Ownership / Principals

5. Investor Profile

Years Investing

Total Investment Properties Purchased

Purchased in Last 3 Years

Properties Owned Today

Typical Financing Method

If Other, describe

Typical Investment Geography

Rental Portfolio Managed By

Years Managing Property

Check all that apply

Licensed Real Estate Agent Licensed Real Estate Broker Mortgage Broker Property Manager Licensed Attorney

Select any professional roles that apply to the primary borrower or guarantor.

6. Loan Purpose / Business Plan

Loan Purpose

Planned Use of Proceeds

Brief Business Plan / Deal Summary

7. Subject Property Information

Property Address

City

State

ZIP

Property Type

Number of Units

Short-Term Rental?

Rented by the Room?

Estimated Property Value

Requested Loan Amount

Requested LTV (if known)

8. Monthly Property Economics

Gross Monthly Rent

Monthly Residential Rent

Monthly Commercial Rent

Monthly Property Taxes

Monthly Hazard Insurance

Monthly Flood Insurance

Monthly Association Dues

Current Insurance Company

Insurance Agent Name

Insurance Agent Phone

9. Property Status / Leasing

How long has the property been rented?

Executed Lease Available?

If no, explain

If vacant, expected monthly rent

If vacant, estimated months to lease-up

Section 8 / Government-Sponsored Renter?

Additional Rental Notes

10. Refinance Section

Acquisition Date

How was the property acquired?

Acquisition Price

Cost of Improvements Completed

Additional Taxes / Liens Paid at Closing

Other Costs

Total Cost Basis

Describe Improvements Completed

Title Currently Held In

Preferred Title Company

Title Contact Info

11. Purchase Section

Purchase Price

Contract Closing Date

Title Company

Title Company Contact Name

Title Company Contact Email

Title Company Contact Phone

Escrow Deposit Paid

Held By

Seller Paid Closing Cost (% or $)

Buying From

Business or Personal Relationship with Seller?

Seller Family Relationship?

If yes, explain relationship

How will title be held?

12. Existing Debt / Liens / Property Condition

Deferred Maintenance?

If yes, describe

Existing Mortgages to Pay Off

Existing Taxes to Pay Off

Existing Judgments

Other Liens

Creditor Names and Phone Numbers

13. Appraisal / Certification

Appraisal Contact Name

Appraisal Contact Phone

Business Purpose Certification

14. Experience Summary

Overall Experience Comments

Completed Rehab / Rental / Ground-Up Projects in Last 3 Years

Active Rehab / Ground-Up Projects

15. Credit & Background Authorization Intake

First Name

Middle Name

Last Name

Date

Authorization Note

Submission note: Once this intake is received, Connected Capital may use the information provided to prepare lender-facing application materials, structure a preliminary term sheet, begin pipeline tracking, and request any missing items needed for underwriting.