Bridgehouse Funding Request

APPLICANT

Applicant Information

Primary applicant contact information.

Applicant Name

Applicant Address

Applicant Email

Applicant Phone

TRANSACTION

Closing Details

Property and transaction information.

Property Street Address

Property City

Property State

Property Zip Code

Purchase Price

$

Re-Sale Price

$

CLOSING

Attorney & Closing Agent

Primary Closing Agent

Name

Phone

Address

Email

Additional Closing Company

Complete this section if multiple companies are being used.

Name

Phone

Address

Email

A-B Closing Date

B-C Closing Date

Comments

BUSINESS

Owners & Officers

Complete for each owner with greater than 25% ownership and/or each officer active in the business.

DISCLOSURES

Other Information

Please answer each question completely.

Are any owners or officers a licensed realtor, licensed real estate broker, or licensed mortgage broker?

No

Yes

Have any owners or officers participated in educational programs for legally and ethically buying and selling short-sale properties, distressed sales, or REO purchases from lenders?

No

Yes

Have any owners, officers, or directors been convicted of, pleaded guilty to, or pleaded no contest to a crime?

No

Yes

Are you, the company, or any owners, officers, or directors of the company currently a party to a lawsuit?

No

Yes

Are there any outstanding judgments against you, the company, or any owners or directors of the company?

No

Yes

CERTIFICATION

Authorization & Signature

I agree to the Voluntary Consent & Confirmation .

I understand that false or misleading information given in this application will result in cancellation. I authorize investigation of all statements contained in this application as may be necessary in the funding process.

I certify that the information above is true and correct and authorize Finger Lakes Funding or its affiliates to perform any background checks as they deem necessary.

Signature of Applicant

Typing your name serves as your electronic signature.

Print Applicant Name

Date

Final Step

Ready to Submit?

Review your information carefully before submitting your funding request.

Funding Request