First Mount Vernon
Industrial Loan Association
6019 Tower Court
Alexandria, Va. 22304
(703) 823-6800
(866) 908-FMV1 (3681)
BROKER'S LOAN APPLICATION
Please complete ALL fields (fields with an
*
are required)
(fields with a
#
are required if there is a second property)
*
Loan Officer:
Company:
Phone:
Fax#:
*
EMail:
Where did you hear about us?
Scotsman Guide
Referral
Fax
Email
Internet Loan Finder
Account Executive
Trade show or other event
Other print material
Name of Borrower:
*
Borrower is:
*
Loan Type:
*
Use of Funds
Individual
Refinance
Business
Partnership
Purchase Money
Investment
Corporation or LLC
Construction/Renovation
Consumer
Trust or Estate
Credit Line
*
Amount Requested:
*
Trust
First Trust
Second Trust
Number of Properties:
1
2
More
Property 1 - Information
Property 2 - Information
Urban Land
Urban Land
Rural Land
Rural Land
Non Owner Occupied Residential
Non Owner Occupied Residential
Owner Occupied Residential
Owner Occupied Residential
Commercial/Industrial
Commercial/Industrial
ADDRESS:
ADDRESS:
CITY:
CITY:
*
STATE:
Delaware
District of Columbia
Florida
Georgia
Maryland
North Carolina
South Carolina
Virginia
#
STATE:
Delaware
District of Columbia
Florida
Georgia
Maryland
North_Carolina
South Carolina
Virginia
Value Information
Value Information
*
Property Value:
#
Property Value:
Existing Trust Information
Existing Trust Information
*
First Trust Amount:
#
First Trust Amount:
Total Property Value:
Total Existing Loans:
Available Equity:
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