Church Finance Broker Application

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BROKER SUBMISSION FORM:

Your Name
Broker's Company Name
Your Title
City and State
How Long in Business?
Type of Broker 
Are You a Licensed Broker?
Yes No
If Yes, License # Here
Do you have an agreement with your client? Yes No
Typical Fee to Clients (points) %
Fee This Client
Are You Dealing Directly With Customer?
Your Telephone Number
Your Fax Number
Your E-mail Address
Your Website Address (URL) If any
Questions or Comments, If Any
HOW DID YOU HEAR ABOUT US? -------------------------------------->

TELL US ABOUT THE CHURCH:

Church Name
Church City & State
How Long in Business (Operating)?
Senior Pastor's Name
How Long Senior Pastor With Church?
Contact Person (Not Broker)
Contact Person Title with the Church
Contact Person Telephone and Fax
E-Mail
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ABOUT CREDIT:
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Do You Personally or Church Have Any Credit Problems? NoYes

If Yes, Please Explain
Any Lawsuits or Litigation Pending or Threaten?
No Yes If Yes, Please Explain
Has Church Been Profitable For The Last 2 Years? Yes No

If No, Please Explain

TYPE OF FINANCING DESIRED:

TYPE OF FINANCING DESIRED: Please Make Selection >>>>>>>> Interim Permanent Refi. New Construction Renovation Purch.
LOAN AMOUNT
Describe Purpose of Loan
Describe Collateral (1st lien only)
Full Narrative Appraisal >>>>>>> Yes No Pending
If Yes, Appraised Value & Date
Appraisal Designation >>>>>>>>> MAI SRA Other Don't Know
Appraiser Name & Phone Number
If No Appraisal, What is Estimated Value?

CHURCH MEMBERSHIP

YTD  2007 2006 2005

AVERAGE SUNDAY MORNING ATTENDANCE

YTD  2007 2006 2005
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YTD & LAST THREE 3 YEARS INCOME & EXPENSE OF THE CHURCH
Fiscal Year Begin Date Fiscal Year End Date
Annual Gross Income Operating Expenses Net Operating Income
YTD
2008 
2007 
2006

EXISTING MORTGAGE & OTHER LIENS:

Current Mortgage 
Other Liens
Name of Current Lender(s)
How Many Other Lenders Have Seen This Deal? 

General Comments or If You Have an
Executive Summary, Please Include Here
(You May Cut and Paste)

If we pass on this deal, would you want to be referred to a another source that might help you place your deal? Yes No

If we pass on this deal, would you want us to refer you to a another source that might help you place your deal? Yes No
Thank you for your application. Because of the high volume of requests, we will only respond to requests that are accepted for further consideration. Please allow 3 business days for an email response. If you do not receive an email response within 3 business days, it means that this particular request was not accepted for further consideration, but please feel free to submit future requests. You are submitting this information for the sole purpose of assisting our corporate financial group division ("CFG")  with its initial screening process, and in no way implies a commitment or obligation on the part of CFG to consider your request or proposal. No oral representation is ever made.  CFG is not obligated to work with any broker. CFG reserves the right to conduct a background check of the broker with the Better Business Bureau and other agencies from time to time,  and at CFG's sole discretion, terminate the relationship with any broker at any time without notice.