Realstate Rescue Program – Client Intake Form

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Saveme@711rescue.com
469-702-8955
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Realstate 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:

Real Estate Type

Years Owned:

Number of Units/Rooms (if applicable):

Property Type:

Property Usage (Please be specific)

Total Square Footage

Occupancy Rate %

Date Property Purchased

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

Loan #

Type of Debt

Interest Rate %

Original Loan Amount

USD

Current Loan Balance

USD

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

Foreclosure Sale Date (If Known)

Are there any ongoing foreclosure or bankruptcy proceedings?YesNo

Please Provide Details

Corporate Structure

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)

Personal Financial Statement(s) for all partners

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Personal and Business Tax Returns - Past two years

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Year-to-date Profit And Loss

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Balance Sheet - Last two years

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Current Accounts Receivable/Payable Aging

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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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Profit & Loss Statement, last 2 years

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Short write-up of present situation

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Short write-up of present situation

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Digital color photos of the Property (Outside and Inside)

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Recent 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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Current Rental and/or Lease Agreement(s)

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Hotel/Motel: ADR Report, STAR Report, Marketing Plan

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Land: Engineer's Reports, Municipality Approvals, Tract Maps

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Commercial: Tenant List, Lease Abstracts, Operating Statements

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

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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 REALESTATE RESCUE program.

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