Brokers

Loan Detail Submission


Please fill out the form below to the best of your ability.
(This form and the data you enter is secured with an encrypted server connection)

Broker Info
First Name
Last Name
Email:
Street Address:
City:
State:
Zip Code:
Work Phone:
Ext:
Cell/Pager:
Fax:
How did you hear of us:
Company:
Broker Name:
Contact me on my:
Email
Cell
Work
   
Best time to contact:
   
Crawford Rep:
Borrower Details
Primary Borrower Co-Borrower
Prefix:
First Name
Last Name
Prefix:
First Name
Last Name
Suffix:
Social Security Number
Suffix:
Social Security Number
Residency
Residency
Entity Name (If Applicable)
Federal Tax ID
Entity Name (If Applicable)
Federal Tax ID
Type of Entity
Type of Entity
Street Address:
City:
Street Address:
City:
State:
 Zip:
 
State:
 Zip:
 
Work Phone:
Cell/Pager:
Work Phone:
Cell/Pager:
Home Phone:
Fax:
Home Phone:
Fax:
Transaction Details
Residential
Commercial
Construction
Land
Occupancy:


Property Use:

Purchase Price


Date Property Acquired:
Loan Purpose

Loan/Line ($) Request:
Property Type:
If Refinance, Original Purchase Price:
LTV: % CLTV: %
Lien Position:
First
Second
Third
Property Details
Subject Property Location:
Address
City
State
Zip
County
Property Type:

SFR   Commercial    Vacant Land   New Construction    

Apartments/Duplex   Mobile Home on Permanent Foundation

   
Does borrower own other real estate they are willing to collateralize? Yes
No
If the above is "Yes," please provide the address(es) and/or APN number(s), city, state, zip, total amount owed on each property, value of each property, current lien positions (1st, 2nd, 3rd), and a brief description of each property:
Improvement Description:
Property Condition: Improvement Square Footage:
Construction Type: Land Square Footage / Acres:
Year Property Built:
Zoning:
Bedrooms: Assessor’s Parcel No:
Bathrooms: # of Units:
Estimated Value: # of Stories:
Additional Details or Other Property Type: (Description)

Construction Loan Info
Construction Cost: 
Estimated Future Value:
Owner/Builder
Contractor
Contractor Name: 
Contractor Address: 
Contractor Ctiy: 
Contractor Zip: 
Contractor Phone: 
Contractor 's Lic. No: 
 
Lien Details
First Position Loan:
Second Position Loan:
Lein Holder Name:
Lein Holder Phone:
Loan Number:
Balance:
Status:
Status Detail:
Status Date:
Disposition:
Remain
Pay Off
  Payoff Amount (if applicable) ($):
Lein Holder Name:
Lein Holder Phone:
Loan Number:
Balance:
Status:
Status Detail:
Status Date:
Disposition:
Remain
Pay Off
  Payoff Amount (if applicable) ($):
Total Liens Balance:  
Credit Information
Bankruptcy
Judgements
Tax Liens
Repossessions
Collections
Have you filed for bankruptcy in the past 12 months?
Yes     No
What Type: 7     11     13
County:
File Date:
Discharge Date:
Foreclosure:
Notice of TD Sale Date:
Sale Date:
Credit Scores:
Experian (FICO)
Trans Union (Emperica)
Equifax (BEACON)
Comments, Special Issues Please indicate any special issues, problems, needs as well as use of funds and exit strategy:
Document Upload
Please upload the following documents:
  Completed 1003 and 1008:
Credit Report:
Appraisal:
  If you are not able to upload the required
documents, please fax to: (909) 882-3230.
Authorization
By checking this box and submitting this form you are acknowledging that you have read and agree to our privacy policy & terms of use and you grant Crawford staff permission to run your customer's credit and to contact you regarding this loan.

You must check the "I Agree" box in order to proceed.