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Project Submission Form

We look forward to working with you on your next project. Before we get started, we need to get a bit more information on your upcoming project. Please fill out the following form to the best of your ability. Please let us know if you have any questions by emailing or calling at 845.432.4674.

Builder Information

First Name*

Last Name*


Phone Number*

Mobile Number

CBC License #

Borrower & Property Information

Project Type:

Borrowers First Name*

Borrowers Last Name*

Co-Borrowers First Name

Co-Borrowers Last Name

Property Address*

Property City*

Property State*


Property Zip Code*

Lot Information:

Cost of Lot

Closing Date

Purchase Date

Original Cost

Current Market Price

Are there any current lenders or lien holders on this property?

Primary Lender or Lien Holder


Project Information

Building Permit Status:

Have you Started Construction?

Describe the improvements made to date:

Photos of improvements made to date:

Select File

Do you have building plans for this project?

Plan set:

Select File

Loan Amount Requested*

Total Hard Cost of Construction (not including land)?*

Market Value When Completed?

Has a Certified Appraisal Been Completed for This Project?

Any Additional Comments:

I/We certify that the information provided is true and correct and authorize Lender to verify information directly or through a credit agency.*

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