DSCR 2nd Lien Intake Form - Brickell Private Lending

Loan Details

Loan Purpose

Purchase

Cash-Out Refinance

Rate-and-Term Refinance

Prepayment Penalty Length (Years)

What is the LTV you are targeting?

Borrower Information

Borrowing Entity Name

Entity Address

Address Line 1

Address Line 2

City

State

Zip Code

Principal(s)

First Name

Last Name

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Phone/Mobile

FICO

How many rental properties do you currently own?

Additional Principal(s) (if any)

Collateral

Property Address

Address Line 1

Address Line 2

City

State

Zip Code

Property Type

Purchase Price

Number of Units

Number of Units Rented

Monthly Rent

Annual Taxes

Annual Insurance

HOA (Monthly, if any)

Are there any Section 8 leases?

Yes

No

Do you live more or less than 50 miles from the subject property?

Less than 50 miles

More than 50 miles

Refinance

Purchase Date

Current As-Is Value

Amount Owned

Completed Renovation

I have read and agree to the Terms of Service and Privacy Policy

By providing your phone number, you consent to receive communications from Brickell Private Lending (Brickell Int’l LLC) via phone, email, or SMS for informational and marketing purposes. Message frequency may vary. Msg & data rates may apply. Reply STOP to cancel or HELP for help. See SMS Program Terms & Consent for details. Consent is not a condition of purchase.