Borrower Intake Form

Thank you for your interest in Medemer Funding. Please complete this form so we can better understand your investment property financing scenario. This form does not guarantee approval or loan terms. All financing options are subject to lender underwriting, borrower qualifications, property eligibility, and applicable local laws.

Borrower Information

First Name *

Last Name *

Email *

Phone *

Preferred Contact Method *

Phone Call

Text

Are you applying as an individual or business entity? *

Select an option

Entity Name (if applicable)

Do you currently own investment properties? *

Yes

These are not your primary residence.

How many rental properties do you own? *

How many fix-and-flip projects have you completed? *

Completion indicates a purchase, rehabilitation, and exit (sale or refinance).

Borrower Financial Profile

Estimated Credit Score Range *

Below 620

620-659

660-699

700-739

740+

Approximate Liquidity Available For This Deal *

Less than $10,000

$10,000 - $25,000

$25,000 - $50,000

$50,000 - $100,000

$100,000+

Do you have funds available for down payment, closing costs, reserves, and potential rehab overruns? *

Yes

Have you been declined by another lender for this deal? *

Yes

If yes, please explain below.

Are you currently working with another lender or broker? *

Yes

Property Information

Address

Property Street Address *

City *

State *

Country *

Enter your country

Postal Code *

Property Type *

Select an option

Is the property currently under contract? *

Yes

I Am Planning Ahead

Purchase Price *

Will you be looking for rehab funding? *

Yes

Estimated Rehab Cost (if applicable)

Estimated Current Value *

Estimated ARV (After-Repair Value) *

Estimated Monthly Rent *

Current Occupancy Status *

Select an option

Property Condition *

Select an option

Loan Request

What type of financing are you seeking? *

Select an option

Requested Loan Amount *

Requested Closing Date *

Is there a hard closing deadline? *

Yes

Exit Strategy *

Select an option

Rehab/Rental Information

For Rehabs: Do you have a written SOW (scope of work)?

Yes

For Rehabs: Who will complete the rehab?

For Rehabs: What is the estimated rehab timeline?

Enter number of months

For Rehabs: Have you completed similar rehab projects before?

Yes

For Rehabs: Do you have contractor bids in hand?

Yes

For Rentals: Current lease in place?

Yes

For Rentals: Estimated monthly rent

For Rentals: Annual Property Taxes

For Rentals: Estimated Annual Property Insurance

For Rentals: Monthly HOA Dues (if any)

For Rentals: Estimated Monthly Property Management Fees

For Rentals: Other Monthly Expenses

Borrower Documents

Documents Available *

Purchase Contract

Scope of Work

Contractor Bid(s)

Rent Estimate and/or Market Rent Report

Lease Agreement

Property Photos

Entity Documents

Bank Statements

Prior Lender Term Sheet

Appraisal or Valuation Report

Insurance Quote

Other

Please upload any relevant documents that might be helpful in our review.

Click to upload

PDF, DOC/DOCX, XLS/CSV, JPG/JPEG, PNG, GIF

Final Questions

What is your main goal with this property? *

What questions do you have about financing? *

Would you like to schedule a loan scenario review call to discuss your financing needs in detail? *

Yes

How did you hear about Medemer Funding? *

Google

Facebook

Instagram

Other Social Media

Email List

Referral

Repeat Borrower

Other

By checking this box, I consent to receive non-marketing text messages from Medemer Funding about project financing needs. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from Medemer Funding at the email and phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

Form Disclaimer

Medemer Funding is a commercial mortgage brokerage focused on business-purpose investment property financing. This form is for preliminary review only and is not a loan application, commitment to lend, or guarantee of approval. Loan terms, rates, leverage, fees, and availability are subject to lender underwriting, borrower qualifications, property eligibility, applicable law, and required disclosures.