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Independent Consultant Request Form
Mortgage Company Name
*
Mortgage Specialist/Officer Name
*
Office Phone Number
Mortgage Specialist Email
*
Cell Phone #
*
Borrower Name/s
*
Borrower Email
*
Borrower Contact Phone Number
*
Property Address
*
City/Zip
*
Number of Units (#s only)
*
Owner Occupied
*
Owner Occupied
Yes
No
Unsure
Investor
*
Investor
Yes
No
Unsure
203(k) Mortgage
*
203(k) Mortgage
Yes
No
Unsure
Loan Type
*
Loan Type
Conventional Rehab Mortgage
Fannie Mae HomeStyle
Freddie Mac Choice
VA-Renovation Loan
Private Lender
Unsure
Estimated Loan/Purchase Amount
*
USD
Maximum Loan Amount
*
USD
Estimated Rehab Amount
*
USD
Date Plan Ordered
*
Date Plan needed by
*
Settlement Date
*
Loan #
*
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