. Broker Submission Form

BROKER SUBMISSION FORM Broker Submission Basic Procedure FOR CHURCH FINANCING CLICK HERE Your Name Broker's Company Name Your Title City and State How Long in Business? Type of Broker  Please Select One Aircraft Finance Business Loans Commercial RE Only Commercial Finance (General) Equipment Loans Residential and Commercial RE Residential Only Other Are You a Licensed Broker? Yes No If Yes, License # Here Typical Broker Fee to Clients (points) % Broker Fee (Points %) This Client Do you have an agreement with this client? Yes No Who Referred This Client To You? Are You Dealing Directly with client or through third party? 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? -------------------------> Please Select One Attorney Bank Other Lender Broker CPA CFG Client C-Loans Alta Vista AOL Ask Jeeves Excite Google HotBot Jayde Lycos MSN Overture Yahoo Other TELL US ABOUT THE DEAL Financing Type Please Make Selection Acquisition Construction - New Construction - Addition FHA/HUD Construction FHA/HUD Refinance Refinance SBA Financing USDA Construction USDA Refinance Other Property Type Please Make Selection Aircraft Apartment Building Car Wash Casino Church Equipment Gas Station Healthcare / Medical Hotel Industrial Property Inventory Office Building Restaurant Shopping / Retail Other Loan Amount If Purchase, What is Purchase Price? If Purchase, Down Payment Available? Desired Terms Project Name Project City and State Type of Property / Collateral Franchise Affiliation (if any) Number of Units or Locations Value of Property / Collateral How Many Years Property / Business Operating? Does Borrower Have Credit Problems or Litigation Pending? - Yes No If Yes, Please Explain Has Borrower's Business or Property Been Profitable For Last 3 Years? - Yes No If No, Please Explain Loan To Value Ratio (LTV) Borrower's Annual Gross Sales Net Operating Income (EBITDA) . Other Information, Executive Summary or Additional Description (You may cut and paste) . How Many Other Lenders Have Seen This Deal?  .   . 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 may 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.