Builder Questionnaire Step 1 of 6 16% Borrower Entity InformationLegal Business Name(Required)Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Type of Entity Borrower Individual InformationYour Name(Required) First Last Your Email Address(Required) Enter Email Confirm Email Home Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home PhoneCell PhoneEstimated Credit Score(Required)Percent Ownership(Required)Track Record(Required)Please select yes or no for the following questions:Have you declared bankruptcy in the last four years?(Required) Yes No Have you had any foreclosures in the last four years?(Required) Yes No Are you presently delinquent on any federal debt or any other loan or mortgage?(Required) Yes No Have you ever been convicted of a felony?(Required) Yes No Are you a US citizen?(Required) Yes No Are you a permanent resident alien?(Required) Yes No Do you intend to occupy the property as your primary residence?(Required) Yes No Are there any outstanding judgements against you?(Required) Yes No Will you have a co-borrower?(Required) Yes No Co-Borrower Individual InformationName First Last Co-Borrower Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Home PhoneCell PhoneEstimated Credit ScorePercent OwnershipTrack RecordPlease select yes or no for the following questions:Have you declared bankruptcy in the last four years? Yes No Have you had any foreclosures in the last four years? Yes No Are you presently deliquent on any federal debt or any other loan or mortgage? Yes No Have you ever been convicted of a felony? Yes No Are you a US citizen? Yes No Are you a permanent resident alien? Yes No Do you intend to occupy the property as your primary residence? Yes No Are there any outstanding judgments against you? Yes No Subject Property InformationSubject Property Address Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Occupancy Leased Vacant Monthly Rental Income (if leased)Property Type SFR Townhome Condo Duplex Triplex Fourplex 5+ Units Other Acquisition Type Standard Short Sale REO Foreclosure Other Loan Request InformationLoan Type Purchase Refinance Loan Term Request 6 Months 12 Months 18 Months 30 Year Other Loan Purpose Fix and Flip Bridge New Construction Long Term Rental Other Purchase Price/Current Value $Estimated After Repair Value $Loan Amount Request $Exit StrategyFor a Refinance, complete the following:Original Purchase Price $Improvements to Date, if any $Year AcquiredCurrent Loan Maturity DateCurrent Debt on Property $Current Loan Interest RateEscrow InformationEscrow/Closing CompanyEscrow/Closing OfficerEscrow/Closing PhoneEscrow/Closing Email Credit and Background AuthorizationBy signing this form I am authorizing Neely Lending Group to conduct a background and credit check. I understand that it is a Federal crime punishable by fine or imprisonment, or both, to knowingly make any false statements when applying for this mortgage, as applicable under the provisions of Title 18, United States Code Section 1014. I also understand that the lender intends to use the data obtained through the investigation for due diligence purposes only, and shall not disclose such information to any other party. Non-Owner Occupancy DisclosureI declare that I have no intention of making the Property (subject property listed in my loan application) my principal residence. I also declare that I have no intention of utilizing the property as a second home and/or any surviving spouse or family member shall live in the property. I understand that this loan is a business purpose loan. I realize the lender, broker, assignees and successors rely upon this information. I declare under penalty of perjury the foregoing in true and correct.Borrower First Last Social Security NumberDate of BirthBorrower SignatureDate MM slash DD slash YYYY Co-Borrower First Last Social Security NumberDate of Birth MM slash DD slash YYYY Co-Borrower SignatureDate MM slash DD slash YYYY Borrower Track RecordPlease list all of the real estate you have owned along with any investment properties sold in the last 36 months (3 years).Property 1: Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Property 1: Vested Name on TitleType of Property 1:Property 1 Purchase Price:Property 1 Purchase Date:Property 1 Rehab Budget:Property 1 Rental Income, if rented:Property 1 Exit Plan:Property 1 Sales Price (if sold):Property 1 Date Sold:Property 2: Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Property 2 Vested Name on Title:Property 2 Type of Property:Property 2 Purchase Price $:Property 2 Purchase Date: MM slash DD slash YYYY Property 2 Rehab Budget:Property 2 Rental Income, if rented:Property 2 Exit PlanProperty 3 Address Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Property 3 Vested Name on TitleProperty 3 Type of PropertyProperty 3 Purchase PriceProperty 3 Purchase DateProperty 3 Rehab Budget:Property 3 Rental Income, if rentedProperty 3 Sales Price, if Sold $Property 3 Date Sold MM slash DD slash YYYY Property 3 Exit PlanProperty 4 Address Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Property 4 Vested Name on TitleProperty 4 Type of PropertyProperty 4 Purchase PriceProperty 4 Purchase Date MM slash DD slash YYYY Property 4 Rehab BudgetProperty 4 Rental Income, if RentedProperty 4 Sale Price, if soldProperty 4 Sale Date MM slash DD slash YYYY Property 4 Exit PlanProperty 5 Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Property 5 Vested Name on TitleProperty 5 Type of PropertyProperty 5 Purchase PriceProperty 5 Purchase Date MM slash DD slash YYYY Property 5 Rehab BudgetProperty 5 Rental IncomeProperty 5 Sale Price, if soldProperty 5 Sale Date MM slash DD slash YYYY Property 5 Exit StrategyAny Additional PropertiesPlease include Property Address, Vested Name on title, Property Type, Purchase Price and Date, Rehab Budget, Sale Price and Date Sold or Rental Income and Exit Strategy Untitled By checking this box, I consent to receive transactional messages related to my account, orders, or services I have requested from Neely Lending Group. 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