GREENMAN FUNDING INFORMATION REQ

(Required information is in Green)

Company Name:
Your Title and First Name:
Your Last Name:
Your Job Title :
Office Address:
City/State/Zip	,
Your E-mail:
Confirm your E-mail:
Work Phone Number/ext:
Work Fax:
URL Address:
Borrower's Net Worth:
Financing Amount Needed:
Property Type:
Property Value or Purchase Price:
Property's Full Address:
Loan Type:
Loan Term (Years):
Amortization (Years):
Anticipated Loan-To-Value (LTV):	%
Anticipated Loan-To-Cost (LTC):	%
Personal Recourse:
Cash Equity:
Additional comments: