CASH OUT

CASH OUT QUESTIONNAIRE

Borrower Name

Entity Name

Nationwide Bankers Representative:

Email Address

Phone Number

Credit Score

Address of Subject Property

Property Type

How Many Units

Property Value (If Refi)

Loan Amount Requested

Loan Purpose

Any Credit Issues in the Past 36 Months

Yes Not

Additional Information

Current Mortgage Rate

Current Amount Owed

Refinance only or Refinance+cash-out

Monthly Rent Received

Monthly Property Taxes

Monthly Insurance

Monthly HOA

Referral person’s name (If applicable)

Current debt