Earnest Money (Deposit) INFORMATION FORM

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Thank your for contacting River Country Capital Solutions for your funding needs. The purpose of this form is to collect information about the "Applicant" (Borrower) and its principals, the EMD request and other information needed in order for the Lender (River Country Capital Solutions) to make a determination regarding eligibility for funding EMD. We work fast and do our best to fund your deals quickly. In order to assure the quickest processing of your EMD funds, please provide all of the requested information. THIS FORM MUST BE COMPLETED BY THE BORROWER IN ORDER TO BE CONSIDERED FOR EMD FUNDING with River Country Capital Solutions.

Applicant Full Name *

Phone Number *

Email Contact *

Applicant Principal Name (Business Entity Name) *

Business Address

Has a Mutual Release form been signed by the parties? *

Yes

EMD Loan Amount Requested?

When Are the Funds Needed?

What state is the property located?

Is the A-B Contract Signed? *

Yes

Required

Is the B-C Contract Signed?

Yes

When is the Estimated Close of Escrow?

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