Low-Interest Loan Inquiry Form
THIS IS NOT AN APPLICATION FOR FUNDING. Preservation Utah receives many inquiries about the low-interest Revolving Loan Fund (RLF). To assist us in processing inquiries, we ask for general information about the project for which funding is being requested, as well as about the borrower(s).

Please fill out this form completely and accurately. This will help the RLF staff serve you better. If you are not able to complete this form yourself, please feel free to contact the Preservation Utah office for assistance.

The information provided on this form shall be used only for processing a preliminary RLF inquiry. It will not be disclosed outside Preservation Utah as required or permitted by law.

Preservation Utah
Memorial House in Memory Grove Park
375 N. Canyon Road
Salt Lake City, UT 84103
(801) 533-0858 | preservationutah.org | historicproperties@preservationutah.org
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Borrower's Name *
Borrower's Mailing Address *
Borrower's Telephone *
Borrower's Email *
Borrower's Current Employer *
Borrower's Years at Current Employer *
Borrower's Annual Income *
Co-Borrower's Name
Co-Borrower's Mailing Address
Co-Borrower's Telephone
Co-Borrower's Email
Co-Borrower's Current Employer
Co-Borrower's Years at Current Employer
Co-Borrower's Annual Income
Other Income Source & Amount
Subject Property Address (include city) *
Must be in Utah
Year property was built *
Approximate date if unknown
Historic name of property (if known)
Is the property in a historic district? If yes, which district?
Date you purchased the property *
Purchase price *
Current assessed value of the property *
Current balance owed of the property *
Monthly payment amount *
Amount of annual property tax *
Do you have a second mortgage/home equity line of credit? *
Is the subject property your primary residence? *
Do you plan to use/keep the subject property as your primary residence after rehab?
Describe any problems you may have regarding your credit history.
Provide a list of your monthly debts (exclude debt service on the subject property) *
List the names of all parties on the title to the subject property, include their relationship to you: *
Briefly describe the improvements you would like to undertake on the subject property: *
What is the total budget for the project? *
What level of funding would you request from Preservation Utah? *
Current square feet *
Square feet after rehab *
Current number of units *
Number of units after rehab *
How did you learn about the revolving loan fund?
Additional comments that could be useful.
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