Business Rescue Program – Client Intake Form

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Business Rescue Program – Client Intake Form

Legal Entity Name That Owns The Property:

Legal Address of Entity:

Property Address

Contact Name (Owner/Partner):

Contact Phone:

Contact Email Address:

Business Type

Industry

Years in Operation

Number of Employees

Property Type and Usage of Each Unit (Please be specific)

Total Number of Units

Number of Vacant Units

Date Property Purchased

Number of Units Occupied By Property Owner

Purchase Price

USD

Current Market Value (Approximate)

USD

Current Net Operating Income

USD

Current Total Debt Amount

USD

LoanFor each loan, please provide the following details:

Lender Name

Original Loan Amount

USD

Current Loan Balance

USD

Loan #

Interest Rate %

Type of Debt

Maturity Date

Total Current Mortgage Balance(s)

USD

Are there any unsecured debts?YesNo

Total Amount

USD

If Not In Default, Is It A Potential Default In Near Future?YesNo

How Long Until Potential Default?

If In Default, How Many Months?

Rents In Receivership With Current Lender?YesNo

Sheriff Sale Date (If Known)

Are there any ongoing foreclosure or bankruptcy proceedings?YesNo

Please Provide Details

Number of Partners/Shareholders

Are you a majority owner?YesNo

Do you have any personal guarantees on the property debt?YesNo

Please Provide Details:

Current Annual Revenue

USD

Current Annual Net Profit

USD

Debt Service Coverage Ratio (DSCR), if known

What is your preferred timeframe for debt resolution?30-90 days91-180 days

Have you attempted any previous debt negotiations or restructuring?YesNo

Please Provide Details:

Please provide any additional information that you believe is relevant to your situation

Third Party Authorization Form

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Fill the form and upload here Click here to Download

711 Rescue Advisory Agreement

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Fill the form and upload here Click here to Download

Payment Confirmation

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(via Zelle or PayPal to Saveme@711Rescue.com)

Financial Information

Personal Financial Statement(s) (1003 or equivalent)

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Personal Taxes - Past two years

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Year-to-date P&L (if self-employed)

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Current Accounts Receivable/Payable Aging

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Business Taxes - Past two years

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Balance Sheet - Last two years

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Loan Information

Most Current Mortgage Statement(s) (for all loans)

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Mortgage Payment History

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All letters and correspondence from your Lender(s) regarding present situation

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Note and Deed of Trust

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Property Information

Profit & Loss Statement, last 2 years

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Short write-up of present situation

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Appraisal (if available, do not order new appraisal report)

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Settlement Statement (HUD-1)

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Property Tax Statement

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Rent Roll and Lease Summary (start dates, expiration dates, etc.)

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Digital color photos of the Subject Property (Outside and Inside)

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Current Rental and/or Lease Agreement(s)

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Legal Documents

Formation Documents (LLC, S Corp, C Corp, etc., ignore if sole proprietor)

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Apartments

If in a rent control area, copy of Rent Control Policy

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If Government Subsidized, copy of all related documentation

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Construction Loans

Construction Cost Breakdown, including costs already paid

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Land Development Cost Breakdown, including costs already paid

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Building Materials Specifications

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Copy of Land Purchase Contract(s)

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Estimated Funding Schedule (detailing the $ amt. and est. date of Construction Fundings)

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Summary of Project's gross leasable, net leasable, parking, etc.

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Stamped, Signed, and Approved Architectural Elevations, or Construction Plans

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Recorded Subdivision Tract Map (Tentative/Final)

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Copy of fully executed Owner-Contractor Contract Agreement (AIA Document A107)

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General Contractor's Resume

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Gas Stations / Car Washes

Copy of Franchise Agreement

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Tank Certification

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Copy of Ground Lease (if applicable)

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Borrower's Resume related to experience in this line of business

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Hotels / Motels

ADR Report (for last three years)

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STAR Report

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Explanation of Marketing Plan

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Average Room County Report (for last 3 years and year-to-date)

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Management Resume and Contract Information

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Original Brochures (if available)

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Breakdown of Facilities (restaurant, convention rooms, gift shops, etc.)

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Manager's Resume and Contract Information

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Mobile Home Parks

Park Owned (number and percentage)

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Breakdown of Homes (single wide, double wide, etc.)

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Marketing Plan, if not long term tenants (i.e. snow birds, casino patrons, etc.)

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Religious Institutions

Number of Members (for last three years) and total Giving Members

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Resume of Primary Board Members and the Pastor/Rabbi/Other

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List of Activities (classes, day care, Bible study, etc.)

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Tracts / Subdivisions / Condo Associations

Breakdown of Units and Phases

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Tract Map

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Breakdown of Models

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Projected Sales Figures

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Breakdown of Cost Per Unit [Model, Sales Price Per Unit, and Model]

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Copy of Plans

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Marketing Plan

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Pre-Sales Report

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Homeowner's Association Documents, Paperwork and Approval(s) (as applicable)

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Land

Copy of Engineer's List and Statement of Requirements and Compliances

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Local Municipality approval to develop the proposed project (signed by Engineer, Owner, and Municipality)

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Engineer's Punch List of Reports and Studies yet to be done

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Copies of all Entitlement Reports and Studies already completed (EIRs, Soils, Traffic, Feasibility, etc.)

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Tentative Tract Map

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Final Map

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County, City, and State Approvals (as applicable)

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Aerial Photos (if available)

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Property Zoning Identification

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Please note:

Not all documents may be applicable to your specific situation. Provide all relevant documents to ensure a comprehensive assessment of your case.

Your Name *

Acceptance

_{name-4}_ (Initial here) By submitting this form, you certify that all information provided is true and accurate to the best of your knowledge. 711 Rescue.com will review your submission and contact you to discuss the next steps in the Business Rescue program.

Thank you for choosing 711 Rescue.com for your business debt resolution needs.