DATE:       FEE:

Lender/Client: COD:

Lender Address:

Phone #                   Fax#   

Loan #         Loan Officer:

E-Mail Address


Loan Type

Conventional FHA FHA Case# 093-

Assignment (Select One)

Purchase Final/Compliance Construction Draw RELO
Refinance Market Value Construction Loan HELOC



Property Type (select one)

URAR (1004)       Condo (1073)
Drive-By Interior (2055) Mobile/Manufactured Addendum (1004c)
2075 Exterior 1025 Multi Family         Units
2070 Interior Final (442)
2070 Exterior Land
Operating Income Statement (216) Rent Schedule (1007)

 Property Address:

City: State:   Zip:   County:

For purchases, please provide purchase price $

sales contract are required for all purchase please fax to 727-863-9400 or e-mail it to

For refinances, borrowers value estimate: $       

For refinances original purchase date: purchase price:   

1st mortgage amount: $   2nd mortgage amount: $

Borrower/Contact Information

Buyer/ Borrower(s) Last name:
Buyer/ Borrower(s) First name:
Co-Buyer/ Borrower(s) Last name:
Co-Buyer/ Borrower(s) First name:

Contact (select one)

Builder Borrower Seller Listing Agent Selling Agent

Contact Name (if other than the borrower)

Home Phone:
Work Phone:
Cell Phone:

Appraisals is needed by: Any seller concession:

Comments/ Special Instruction:


Fee Schedule

Single Family $250.00 FHA (SFR/Condo) $275.00 Drive-By Ext $150.00
Condo $250.00 Vacant Land $225.00 Drive-By Int $225.00
Multi-Family (Investment 2-4 Units) $425.00 Insurance Appraisals $175.00


Fee Schedule

Single Family $275.00 Condo $275.00

** Please call for a quote on atypical and jumbo properties**

Single Family Rent Schedule $75.00 Draw/Final (Each Inspection) 75.00 Desk Review $150.00
Operating Income Statement $75.00 FHA Compliance Inspections (each) $75.00 Field Review $225.00

**Fee are subject to change based on complexity or atypical assignments**

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