Loan Application

Please fill out our Application form below and we will get in touch with you shortly.

Full Name:
Your Email Address:
Phone Number:
I am a:
Subject Property Address:
Property Type:
Square Footage:
Use of Property:
Year Built:
Condition:
Date of Purchase:
What did, or will you pay for the property?
Estimated Current Value of Property?
Requested Loan Amount:
Are there any other loans on Property?
If so, how much?
Loan Term Requested (months):
Purpose of Loan:
Loan Must Close by (Day, Month, Year):

If you have photos to upload for this property, please e-mail them to dan@privatemoneydr.com

DAN M. RUSSEL, BROKER | PHONE: 619.933.7117 | FAX:619.270.9847 | DAN@PRIVATEMONEYDR.COM

CA DRE LIC:00553696 | 1231 HIDDEN MOUNTAIN DRIVE, EL CAJON, CA 92019