Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Target Close Date

MM

DD

YYYY

Will project require permits?

No

Yes, received

Yes, pending

Expected time in project

0-6 Month

6-12 Month

12-24 Month

Loan Exit Strategy

Sell

Refi to long-term

Other

Company - Contact Name *

First Name

Last Name

Phone

(###)

###

####