203k Consultation Request Form
203K HUD# S0812
Borrower's First & Last Names: *
Name(s) as you want them on the paperwork
Borrower's Email: *
Borrow's Home/Office Phone:
Borrower's Cell Phone: *
Subject Property full Address - include city & state *
Number of Units:
Leave blank if only 1
Purchase or Refinance?
Renovation Loan Type:
Choose which service you need
Estimated Rehab Amount($):
Construction budget amount
Real Estate Agent Name for access to the property:
Real Estate Agent's phone #:
Real Estate Agent eMail:
Purchase Price($):
Skip if a refinance
Estimated Loan Amount($):
Termite will be included in work write-up:
Termite work Completed by Seller:
Septic & Well Cert will be included in work write-up:
Septic & Well work Completed by Seller:
Property is on City Water /Sewer
Contractor Name:
Contractor Phone:
Contractor License #:
Contractor email:
# of payments financed into Loan:
1-6 only
Notes or comments
Exhibits submitted to consultant at the time of request:
Lender and LO name:
Lender Address if this is your first order:
Okay to leave blank if you are a recurring customer
Lender Address if this is your first order:
Loan Officer Phone:
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