International Commercial Loans

		Skype: klauslabuttis
USA:	Tel: +1.267.439.4398	Fax: +1.786.513.0489

klaus@international-commercial-loans.com

Short Intake Form (Strictly Confidential)

Date Submitted: Loan Amount Requested

Principal's Name(s):

Company:

Address:

City/State/Zip:

Phone: Fax: Email:

Broker's Name:

Company:

Address:

City/State/Zip:

Phone: Fax: Email:

Purpose of Loan:

Description of Loan:

AS-IS Value: $ AS-Improved Value: $

AS-IS Disposition Value: (3-4 MO.Sale) $ AS-Improved Value: $

Existing Debt: Payable To:

Plan For Repayment of Loan: