Real Estate Wealth Network Funding Request Form
Name:
Address:
Email:
Phone:
Closing Details
Property Address:
Purchase Price:
Re-Sale Price:
Attorney and/or Closing Agent (Provide additional information if multiple companies are
being used)
Name:
Address:
Phone/Fax/Email:
A-B Closing Date:
B-C Closing Date:
Comments:
Return all documentation by:
Email: Team@Fundaflip.com
Fax: (888) 611-8828 eFax
I understand that false or misleading information given in this application will result in
cancellation. I authorize investigation of all statements contained in this application as
may be necessary in the funding process.
Signature of Applicant Date
COMPANY INFORMATION:
Company Name:
DBA’s or Affiliates:
Company Address:
Phone #: Fax #:
Email Address: Web Address:
Corporation Partnership LLC Sole Proprietorship
Federal Tax ID #:
List full names and the % ownership of all owners with > 25% interest:
OTHER INFORMATION:
Are any of the owners / officers a licensed realtor, licensed real broker, or licensed mortgage
broker? No If yes, please list names, license type, license #:
Have any of the owners / officers participated in educational programs for legally and ethically
buying and selling short-sale properties, distressed sales or REO purchases from lenders?
No If yes, please list programs / dates attended /explain in as much detail as possible:
Have any of the owners or officers and /or directors been convicted, plead guilty or no-contest to
a crime? No If yes, please explain in detail:
Are you, the company or any of the owners or officers and /or directors of the company party to
a lawsuit? No If yes, please explain in detail:
Are there any outstanding judgments against you, the company, or any of the other owners
and/or directors of the company? No If yes, please explain in detail:
Please attach / send copies of the following:
Articles of Incorporation/Organization
Bylaws or Operating Agreement
Certificate of Good Standing from state
Any professional licenses for owners / officers.
For each owner > 25% and/or officer active in the business:
Name:
Home Address:
DOB:
In addition, please scan a legible copy of your driver’s license.
I certify that the information above is true and correct and authorize Fund - A - Flip or their
affiliates to perform any background checks as they deem necessary.
Signature: Title: Date:
Name:
Home Address:
DOB:
In addition, please scan a legible copy of your driver’s license.
I certify that the information above is true and correct and authorize Fund - A - Flip or their
affiliates to perform any background checks as they deem necessary.
Signature: Title: Date:
Name:
Home Address:
DOB:
In addition, please scan a legible copy of your driver’s license.
I certify that the information above is true and correct and authorize Fund - A - Flip or their
affiliates to perform any background checks as they deem necessary.
Signature: Title: Date: