Hard Money
Private Money

Richmond Mortgage Inc.

Hard Money, Private Money

5-Minute Loan Application

This loan application is for:

After filling out the form below, click ‘Submit’ at end of the form or print and fax to 804 288-1899.

    Required fields are in *Bold

    Borrower Information

    Borrower name:

    Borrower address:

    Borrower company:

    Borrower e-mail address:

    Borrower phone number:

    How much cash do you have to put toward the project?:

    Do you have the property under contract?
    YesNoMaking an offer

    Property Information


    Property description:

    Purchase price of property:

    If the property is a single family residence, is there a master bath and 1 full bath that is not a master bath?:

    If there is not currently a master bath, do you plan on adding one?:

    Construction type:
    Site-built constructionManufactured/modular construction

    Seller Information

    Property listed on MLS, CoStar, or Loop Net?
    Please check all applicable boxes:
    MLSCoStarLoop Net

    If on MLS give the MLS ref #:

    Name of property seller (assigned contracts require approval):

    How long has the seller owned the property?:

    Info on any existing leases:

    Rehab Checklist

    Roof Needed:
    Rip & Replace (single)Full Roof (Multi)1 Layer or Shingles Added
    Roof Cost:

    Exterior Paint/Siding Needed:
    Exterior Paint/Siding Cost:

    Garage Repair Needed:
    1 garage door w/ openerreframe structure1 car paint2 car paintnew roof
    Garage Repair Cost:

    Yard Landscaping or Cleaning Needed: yes
    Yard Landscaping or Cleaning Cost:

    Heating, HVAC:
    HVAC & ductworkHVAC unit onlyBoilerHot Water Heater
    Heating/HVAC Cost:

    Full Rough-InMinor Repair
    Plumbing Cost:

    Re-wire entire houseminor changesNew panel
    Electrical Cost:

    Foundation/Basement Repair:
    Reframe support beamReplace/Sister joistSeal BasementJack-up houseConcrete
    Foundation/Basement Repair Cost:

    Interior Paint Needed: yes
    Interior Paint Cost:

    Flooring Repair:
    CarpetVinylTileConcreteRe-finish hardwoodNew Hardwood
    Total S.F.:
    Flooring Repair Cost:

    Kitchen Repair/Appliances:
    Kitchen Repair/Appliances Cost:

    Bath Repair:
    Full renovationChange fixtures only
    Number of Baths:
    Bath Repair Cost:

    Framing/Insulation/Sheetrock Repair:
    Move wallsInsulationSheetrock repair
    Framing/Insulation/Sheetrock Repair Cost:

    Dumpsters?: yes
    Dumpster Cost:

    Porch/Deck Repair:
    Tear down & re-do new?Repair existing?
    Porch/Deck Repair Cost:

    Window Repair:
    ReplaceStorm windows
    Window Repair Cost:

    Well/Septic Repair:
    WellSeptic tank
    Well/Septic Repair Cost:

    Oil Tank Repair:
    Above groundIn ground
    Oil Tank Repair Cost:

    Demo Cost:

    Other Repair Costs:


    Total Rehab Cost:

    Additional rehab comments:

    Exit strategy: (If selling, what is your sales price):

    How many fixes & flips have you done in the last 12 months? List address, purchase amount, rehab cost and sale price:

    Would you like to request a pre-approval letter?:

    Send all photos, videos and attachments to: Mike@RichmondMortgageinc.com

    Please contact us if you do not receive a reply within 24 hours.
    Phone: 804-249-2887
    E-mail: mike@richmondmortgageinc.com

    Richmond Mortgage Inc.

    Richmond Mortgage Inc.