IMC Mini Application

Application
Please note that all fields followed by an asterisk must be filled in.
First Name* First Name*
Last Name* Last Name*
E-mail Address* E-mail Address*
Web Site URL
Street Address* Street Address*
City* City*
State/Prov* State/Prov*
Zip/Postal Code* Zip/Postal Code*
Country* Country*
Home Phone* Home Phone*
Business Phone* Business Phone*
Fax
Project name
For this Project I am:
Purpose of the Loan
Amount of Loan Requested $
Purchase Price $
Cap Rate %
"As Is Appraised Value" $
Completed Value $
Loan to Cost %
Total Cost of Construction
Amount of Down Payment $
Property/Business Address -Line 1
Property/Business Address-Line 2
City
State
Zip Code
Property County
Property Type
If A Business Loan, Type of Business
Gross Rentable Area (sq. ft.)
Net Rentable Area (sq. ft.)
Number of Units
Number of Vacancies
Vacancy Rate for the Area?
Description of the Property and/or Business
Age of the Property and or buiness (years)
Describe Special Issues, Problems, or Needs
Use of the Proceeds
Total Business Revenue $
Net Operating Income?
Additional Comments
Please enter the word that you see below.