Mortgage Cap Financial Application Form

Mortgage Cap Financial

Pre-Qualification Worksheet

The Pre - Qualification Worksheet's purpose is to allow us to review the prospective

transaction to determine the feasibility of further action prior  to issuance of a formal

Termsheet / Engagement / Conditional Commitment

A)

BORROWER INFORMATION

Legal Ownership:

Individual

Partnership

Corp.

LLC

Borrower Name:

Co-Borrower's Name:

Borrower Contact (if different):

Principals or Guarantors:

Contact Info.:

Phone:

Fax:

Phone:

Fax:

Phone:

Fax:

Phone:

Fax:

Phone:

Fax:

Name of Borrowing Entity:

Address of Entity:

Borrower's Credit:

Great

Good

Fair

Poor (Why?)_______________________

Ever declare Bankruptcy?

No

Yes

If YES what Year

Discharged Date: ( MM/DD/YR)

Please provide details of Bankruptcy:

B)

PROPERTY INFORMATION:

Name of Project:

Address of Project:

Property Type:

Healthcare

Mixed Use

Professional Owner Occ.

Land

Hotel/Motel

M/Home Park

Retail/Shopping Center

Mini-Storage

Industrial

Multi-Family

ALF./Senior Citizen

Retail/Office

Other

B)

PROPERTY INFORMATION continued:

Occupancy:

Non-Owner Occupied

100% Owner Occupied

(if Applies)

Partially Owner Occupied

% of Ownership

%

Property Size: # of Units: (1)

or Gross Leasable Area:

sq. Ft.

Current Occupancy:

%

Last Years Percentage

%

Full Year (Net Operating Income):

$                                            -

(Breakdown Pg 5)

(Please check one)

Estimated

or

Actual

Year Built:

Year Renovated:

Title Form:

Fee Simple

Leasehold

Property Physical Condition:

Great

Good

Fair

Poor

Last Appraisal Date:

Value:

$-

Borrower's Estimate of Current Value:

$-

C)

MORTGAGE LOAN REQUEST

Requested Loan Amt.:

$-

Requested Rate

%

Total Value of Project:

$-

(cost if purchase)

Acceptable LTV:

%

Collateral

What is the Real Equity in the deal?

$-

Is Equity cost minus loan request,

Yes

No

Are you willing to have and Equity Partner?

Yes

No

Ownership % available to Lender (if applicable)

%

Loan Type:

Refi

Const.

Purchase

Bridge

Cash Out Refi

Hard Equity

Income Producing:

Yes

No

Construction Time:

Yr. Renovated:

(If Applies)

Source of Repayment:

For what will the funds be used        (Be Specific, List Dollar Amounts)

See Attached Bid/Cost breakdown

Land

$-

$-

Engineering

$-

$-

Building

$-

$-

F F & E

$-

$-

$-

$-

$-

$-

$-

$-

SUB TOTAL

$-

SUB TOTAL

$-

TOTAL

$-

D)

CASH FLOW 1st YR.

Yearly

Monthly

Cash Flow Estimate

$-

$-

Gross Receipts

$-

$-

Expenses

Depreciation

$-

$-

Franchise fees

$-

$-

Interest Expenses

$-

$-

Office Expenses

$-

$-

Postage

$-

$-

Professional Services

$-

$-

Repairs & Maintenance

$-

$-

Salaries

$-

$-

Taxes-Payroll

$-

$-

Taxes-Other

$-

$-

Utilities

$-

$-

Other

$-

$-

Other

$-

$-