17 Rogers Street, 3rd Floor, Gloucester, MA. 01930
(T) 978.283.9208
(F) 978.283.1957

 

 Home | Site Map | Contact Us 

 

Loan Programs

Loan Inquiry Form

Rockport Mortgage Corporation
17 Rogers Street
3rd Floor
Gloucester, MA 01930
Tel: (978) 283.9208
Fax: (978) 283.1957
E-mail:info@rockportmortgage.com

Rockport Mortgage can send you a quote regarding the financing of your project. Please fill out the information in this form and click on "send message" as indicated at the bottom of the form. You will hear from us in two (2) business days. Thank you.

*Required Information

Contact Information

*First Name/ Middle Initial:

*Last Name:

Title:

*Company:

*Address 1:

Address 2:

*City:

*State:

*Zip:

*Phone:

Fax:

*Your Email:

Web Address:

   

We Are... (check all that apply)

Multifamily owner

Lawyer

Assisted Living/Retirement Housing Owner

Mortgage Banker Broker

Commercial Banker

Not-for-Profit

Commercial Real Estate Developer

Nursing Home Operator

Financial Consultant

Real Estate Broker

General Contractor/Builder

State Healthcare/Senior Housing/Assisted Living Association

Healthcare Consultant

Unclassified

Healthcare Receivable/Equipment Lender

 

 

       

Property Information

Name of Property to be Financed:

*Street Address:

*City:

*State:

Zip:

       

Type of Property (Check All That Apply)

Senior Housing/Long-term Care Facility

Nursing Home

Board and Care Facility

Assisted Living Facility

   

Acute Care Facility

Diagnostic Center

Psychiatric Hospital

Hospital

Rehabilitation Center

Special Purpose Center

   

Commercial Real Estate

Apartment Building/Complex

Office Building/Complex

Industrial Building/Complex

Retail Building/Complex

 

Please Describe:

 
 

Information About Your Financial Request

Dollar Amount:

   

Type of Financing Requested

Bridge Loan

Participating Mortgage

Construction/Permanent Loan

Refinancing Permanent Loan

Acquisition Financing

Expansion Loan

 

other:

 

Unit, Rent Breakdown (Current Rent Roll)

Unit Mix

# of Units

Current Rent

Estimate of Market Rent

0 Bedroom

1 Bedroom

2 Bedroom

3 Bedroom

4 Bedroom

Totals

 

Physical Condition Information

Estimate of Rehab Needs:

Existing Debt:

Replacement Reserve Balance:

 

Audited Income and Expense Data From Audit Year

Income

Gross Potential Rent

Laundry Income

Other Income

Vacancy

Effective Gross Income

Expenses

Administrative

Management Fee

Utilities

Operating and Maintenance

Taxes and Insurance

Other

Replacement Reserve Deposits

Total Expenses

Per Unit Expenses

Net Operating Income

 

Projected Income and Expense Data For Next 12 Months

Income

Gross Potential Rent

Laundry Income

Other Income

Vacancy

Effective Gross Income

Expenses

Administrative

Management Fee

Utilities

Operating and Maintenance

Taxes and Insurance

Other

Replacement Reserve Deposits

Total Expenses

Per Unit Expenses

Net Operating Income

   

Comments

 
 

privacy policy | disclaimer

 

© 2002-2007 Rockport Mortgage Corporation