Connected Capital Application

Full Name *

Social Security Number *

Date of Birth *

Estimated Credit Score *

Primary Phone number *

Type (Home, Mobile, Business, other) *

Email address *

Marital Status *

Please select at least one option.

Unmarried

Married or Separated

Name of Spouse

Current Street Address *

Current City *

Current State *

Current Zip Code *

Do You *

Please select at least one option.

Own

Rent

Number of Years at Current Address *

Mailing Street Address if Different from Current

City

State

Zip Code

Employer Name *

Employer Street Address *

Employer State *

Employer City *

Employer Zip Code *

Self Employed

Please select at least one option.

Yes

Position *

Years on Job *

Years in Profession *

Gross Annual Income *

Secondary Employer Name (if applicable)

Secondary Employer Street Address

Secondary Employer City

Secondary Employer State

Secondary Employer Zip Code

Secondary Employment - Self Employed?

Please select at least one option.

Yes

Secondary Employment Position

Secondary Employment Years on Job

Secondary Employment Years in Profession

Secondary Employment Gross Annual Income

How often do you get paid? *

Please select at least one option.

Weekly

Bi-weekly

Bi-Monthly

Monthly

Transaction Type *

Please select at least one option.

Purchase

Cash-Out Refinance

Rate & Term Finance

Subject Property Address *

Subject City *

Subject State *

Subject Zip Code *

Condo *

Please select at least one option.

Yes

No

Unit No. (if any)

Subject Property Type *

Please select at least one option.

Residential 1-4 Family

Mixed Use Property 5+ Units

Commercial Apartment Building

Vacant Lot with Approvals

Vacant Lot without Approvals

Purchase Price or Requested Loan Amount *

Renovation Funds Requested (if any) *

Estimated Current Value of Property *

Estimated Value of Property After Repair *

Please check below the documents you will be uploading today:

Please select at least one option.

2 Most Recent, Consecutive Paystubs

Last 2 Months Bank and/or Asset Statements (all pages all accounts)

Purchase Contract

Project Construction Budget Estimate (if it applies)

Schedule of Real Estate Owned and Sold (Real Estate experience template available in our 'Download' tab)

Copy of Valid Government Issued ID (Driver's License or Equivalent)

Copies of Corporate Documents for the Borrowing Entity

Most Recent Mortgage Statement for all Properties Currently Owned

Most Recent Personal Financial Statement (PFS template available in our 'Download' tab)

File upload (.PDF, .IMG, .JPG, .BMP, .TIF files only)

Additional Notes (if any)

Client Authorization & Declaration: *

Please select at least one option.

By clicking here, you acknowledge that this website uses up-to-date encryption technology to ensure the confidentiality of all information required. You also acknowledge that this website makes a best effort attempt to prevent external factors from compromising the security of the information exchanged herein.

By clicking on this box, you acknowledge that you have read and understood the company's privacy policy.

Connected Capital Funding LLC