Interest Form
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Please Fill Out And Fax This Form

To (901) 202-4472 ext. 213

 

Name _______________________________________________ Date ____________

Address ______________________________________________________________

City____________________________________State _________Zip _________

Phone  Day ________________ Eve _________________ Fax _______________

YES! I would like to get started as soon as possible. Please call me when you get
a loan to place.

YES! I’m very interested but I have some questions I’d like to discuss one-on-one.
Please contact me to schedule a meeting.

NO! I’m just not ready to be a private lender at this time.

I have some friends I believe would like to learn about private lending.

You May May not   use my name when contacting them.

Name ______________________________________  Phone __________________

Name ______________________________________  Phone __________________

I have available for lending at this time.

$5,000 - $25,000 $25,000 - $50,000 $50,000 - $75,000
$75,000 - $100,000 $100,000 – Plus  

Part or all of my funds are in an IRA    Yes    No