Borrow - Coastal Capital Lending

Borrowing with us is as easy as filling out this form!

Personal Information & Property Information Form

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Company Name (All Loans Must Close In An Entity’s Name)

Please list the full name and emails of all entity shareholders that have 10% or greater ownership.

Shareholder 1 Name

Shareholder 2 Name (if no others, put N/A)

Other Shareholders (if no others, put N/A)

Shareholder Email

Shareholder 2 Email

Other Shareholder Emails

Phone Number

How Did You Hear About Us?

If Referral or Other, please explain

How many deals have you completed in the last 36 months?

Have you had a foreclosure, deed in lieu, or short sale in the past 7 years?

Estimated Credit Score?

Important Information About Procedures for Opening a New Account

To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account.

What this means for you: When you open an account, we will ask for your name, address, date of birth and other information that will allow us to identify you. We may also ask to see your driver’s license or other
identifying documents.

Property Address

Property Type

If “Other” please describe

Number of Bedrooms (please indicate per dwelling count if multiple dwellings)

Number of Bathrooms (please indicate per dwelling count if multiple dwellings)

Total Square Feet

Projected Closing Date

Loan Type

Purchase
Refinance

Loan Type

Loan Term: 6 Months

Requested Loan Amount ($)

Purchase Price ($)

Rehab Amount ($)

After Repair Value ($)

Rehab/Repairs

Exit Strategy

Does The Property Have a Basement?

How Many Stories is the Property?

Are You Adding Square Footage?

Attorney/Title Company Name & Contact Information

Please leave the name of the contact, phone number, and email address.

Insurance Company/Agent Name & Contact Information

Please leave the name of the contact, phone number, and email address.

Additional Comments

Borrowing with us is as easy as filling out this form!

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