CONTACT INFORMATION FORM: AMERICAN FUNDING RESOURCES toll free 1-800-939-1086 Eastern time. * To move between fields, hit your "TAB" key, rather than your "ENTER" key.* NOTE: The first 5 (required***) fields MUST be filled in BEFORE you can submit your Request. * IMPORTANT: After filling out the Form, please FIRST fill in the Security Code at the bottom, and THEN hit "Submit".* A copy of the completed Form will be emailed to you shortly after you submit it.


Your Full Name***
I am:***
Your Email Address***
Telephone*** ( xxx-xxx-xxxx )
Best Time to Contact You / and Your Time Zone***
Desired Loan Amount ( $ 500,000 min. loan )
Purpose of Loan
Property Type
Property Description ( detail )
Full Address of Property
County
Property APN ( parcel # )
Est. Appraised Value ( as is )
Est. Appraised Value, ( with planned improvements )
Purchase Price ( if applicable )
If Purchase, Are You Under Contract ?
 Yes 
  No  
Payoffs Required - if Refinance
If Refinance, Use of Proceeds ?
Annual Gross Operating Income
Annual Operating Expenses ( Actual )
Land Size ( acres )
Number of Buildings
Age of Building(s)
Number of Stories
Condition of Building(s)
Current Occupancy Level ( % )
Prior Year Occupancy Level ( % )
Do You Have a Current Appraisal ?
 Yes 
  No  
Do You Have a Current Rent Roll ?
 Yes 
  No 
Will the Property be Owner Occupied ?
 Yes 
  No  
What Business Activity will take place on the Property ?
Are any Units Occupied by You ?
 Yes 
  No  
Property is, or will be held in name of ...
Borrower # 1's Credit
Borrower # 1's Net Worth
Borrower # 2's Credit
Borrower # 2's Net Worth
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