The Interbanc Group

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CRE Loan Intake Sheet

Date:

Broker Name	Company	Cell#	Phone#	E-mail

Company / Project		Contact Name
Address		Cell Phone#
City, State & Zipcode		Fax#
Company Phone#		Email Address
Web Site

Type of Business Entity
	Corporation		Ltd. Partnership		Subchapter S Corp.
	Limited Liability Comp		Sole Proprietorship		General Partnership
	Individual (Business Purpose)		Trust		Other

Amount of Loan Requested

$

Requested Term of Loan

Requested Amort.Term of Loan

Type of Property
	Multi-Family		Industrial		Restaurant		Construction
	Office		Light Industrial		Franchise		Mixed Use
	Retail		Mobile Home Park		SFR Tract		Church
	Hotel / Motel		Gas Station		Land

Specific Loan Purpose
	Purchase Subject		Refi Cash - Out		Construction
	Refi Rate & Term		Upgrade / Remolding		Buy-out Partner(s)
	Purchase Another Property		Hard Money		Bridge Loan

Year Built	#Units	GRSF	NRSF	#Parking	#Floors

Purchase Price	Outstanding Balance	Appraisal Value	Liens	Date Purchased	Maturity Date	Interest Rate
$	$	$	$			%

PROCEEDS USE
	$ Amount
Real Estate Acquisition	$
New Construction	$
Expansion / Repair	$
Land Purchase	$
Loan Fee's	$
Acquisition of Existing Business	$
Payoff Bank Loan	$
Retire 2nd	$
Other	$
Other	$
TOTAL PROJECT	$
CAPITAL INJECTION / DOWN PMT.	$
LOAN AMOUNT	$

Guarantors Net Worth	$

RENT ROLL
	Current
Annual Rents	$
CAM Expense	$
Other Income	$
SUB-TOTAL	$
Less: Vacancy	$
GROSS RENT	$
Taxes	$
Insurance	$
Management Fee	$
Expenses	$
Reserves	$
TOTAL EXPENSES	$
NOI	$

Guarantors Liquidity:	$