Application

Borrower Information

Full Name Date of Birth
Social Security Number Florida Driver's License Number
E-mail Address Primary Phone
Cell Phone Street Address
City State
Zip Code Occupation
Net Worth Average Income Over Last 3 Years

Corporation Info

Corporation Name State of Incorporation
EIN

List All Owners

Owner One:
Full Name Phone Number
E-mail Address Cell Phone Number
Address City
State Zip

Owner Two:
Full Name Phone Number
E-mail Address Cell Phone Number
Address City
State Zip

Owner Three:
Full Name Phone Number
E-mail Address Cell Phone Number
Address City
State Zip

Property Information

Address Type of Real Estate
New Purchase or Refinance New PurchaseRefinance
Purchase Price, if Purchase Requested Loan Amount
Amount of Down Payment, if Purchase Requested Loan Term
Requested Closing Date As-is Value
As-is Equity Condition
Estimated Cost of Repairs After Repaired Value
Property Type Square Footage
Is This a Rental? If so, is it Occupied? Approximate Structure Age? Roof? AC?
List All Liens. Are there existing mortgages or back taxes? Are they current?
Recent Appraisal Annual Taxes and Insurance
Additional Property Comments. Please provide a brief summary of purpose of loan, timeline, and exit strategy. (e.g. sale of asset, refinance, rent/hold, etc. (Please be detailed.)
Realtor Name, If Involved Realtor Phone
Realtor E-mail Title Company
Closing Agent Closing Agent's Phone
Closing Agent's E-mail

Experience

Real Estate Investing Experience? YesNo
Number of Properties Completed
Rehab/Construction Experience? YesNo
Year's Experience
Do you have any projects in progress? YesNo
Number of Current Projects
Investment Properties Currently Owned (include address and note if rented or vacant)
Do you have any professional licenses? Additional Collateral Available?
What is Your Exit Strategy
Have you applied for other conventional or private financing? If so, what was the outcome?
How did you hear about us?
Any additional notes

Background Information

Are you a U.S. Citizen? YesNo
Have you or any of your businesses ever filed for bankruptcy? YesNo
Are t here any judgments against you or any of your companies? YesNo
Are you or any of your companies currently involved in a lawsuit? YesNo
Are you presently delinquent or in default of any Federal debt or obligation? YesNo

Acknowledgement & Agreement

The undersigned specifically acknowledges and agrees that (1) all statements made in the
Application are made for the purpose of obtaining a Commercial Loan (s) with First Capital Trusts, LLC it’s Sources, Agent, Successors, and/or Assigns (2) the Loan is a Commercial
Loan used for Business Purpose only and shall be unoccupied and NOT used for Residential
Purposes (3) Verification and /or Re-verification of any information contained in Application
may be made at any time by First Capital Trusts, LLC it’s Sources, Agents, Successors, and /or
Assigns and will rely upon the information provided in this Application and I/we have the
continuing obligation to amend and/or supplement the information provided in any of the facts
which I/we have represented herein should change, (4) the loan may be transferred to Successors
or Assigns of First Capital Trusts, LLC it’s Sources, Agents, Successors, and/or Assigns without
any prior notice to me; (5) First Capital Trusts, LLC it’s Sources, Agents, Successors, and/or
Assigns make no representations or warranties, express or implied, to the Borrower(s) regarding
the property, the condition of the property, or the value of the property.
CERTIFICATION: I/WE certify that the information provided in this Application is true and
correct as of the date(s) set forth opposite my/our signature(s) and acknowledge my/our
understanding that any intentional or negligent misrepresentation of the information contained in
this Application may result in civil liability and/or criminal penalties including, but not limited
to, fine or imprisonment or both under the provisions of Title 18, United States Code, Section
1001, et seg. and liability for monetary damages to First Capital Trusts, LLC it’s Sources,
Agents, Successors and/or Assigns and any other person who may suffer any loss due to reliance
upon misrepresentation which I/We have made on this Application.

I Agree to the Above

Sign your name by entering in the fields below followed by the date:
Investor Signature Date
Co-investor Signature Date