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Co-Broker Summary Form
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Originator
Project Name
Contact Name
Date
Referred By
Company
Phone
Fax
Mobile
Location
Purpose of Loan
Residential / Commercial: SFR  Multi-Family  Retail  Office  Industrial  Mixed Use  Hotel  Mobile  Other  Lots  Land
Construction: New  Broken Priority  Development
Property Information
Zoning
Parcel Number
Address
Type of Construction
Date Acquired
Purchase Price $
Squ. Ft.
Amount Down $
Est. Bldg. / Land Value $
APPRAISAL Yes  No
Date
Loan Request
Amount $
Co-Broker Payment $
Term
Approx. LTV
Guarantor Name
Guarantor Credit Score
Requested Close of Escrow
Encumbrances
Seller Carry?
Amount $
1st Lein Holder
Amount $
Rate
2nd Lein Holder
Amount $
Rate
Underwriting Use Only
VWCI
AFFIL
PI
Date