Private & Confidential

Pre-Qualification Questionnaire

The purpose of this questionnaire is to pre-qualify Commercial Tenants for our Lease to Own Financing program. The answers will help us determine what financing approach will work best for your needs.

All information you provide will be kept confidential.

Please complete as much of the form as you can (and print a copy for yourself) and then submit this form (use the Submit button below; it will automatically be sent by email to us) -- or fax to 973-300-5486 before contacting us. (In these questions the Renter is also referred to as the Tenant or Owner of the Business, while the person or company that owns the real estate and building is referred to as the Landlord; we help Renters buy-out their Landlords).

You can email us at: lease-ownership@usa.net

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1. Name of Tenant (business owner legal name):

Address: State: Zip:

2. Tenant Phone Number, Fax Number and email:

3. Name of Tenant Owner/Contact Person:

4. Name and address of Landlord:

5. Location of Property:

6. Tenant estimate of Property Value:

7. Estimated value of all Tenant business fixtures and equipment, including vehicles: $

8. Have you spoken to your Landlord about buying the property? Yes No

9. If we contract with you, may we contact your Landlord? Yes No

10. Does your Lease have an Option to Buy Clause? Yes Price? $ No

11. What is your current monthly rent (do not include taxes or other charges)? $

12. What are the current Real Estate Taxes, per month: $

Criteria that may apply for particular programs (answer each):

1. Is Estimated Property Value at least $250,000? -- Yes No N/A Unknown

2. Is Loan Amount likely to exceed $2,000,000? --Yes No N/A Unknown

3. Is Seller (Landlord) willing to hold up to 5% 2^nd? -- Yes No N/A Unknown

4. Can Tenant show a 5/10% down payment? -- Yes No N/A Unknown

5. Can Tenant show a 25% down payment? -- Yes No N/A Unknown

6. Can Tenant show 3 years tax returns? -- Yes No N/A Unknown

7. While the personal credit rating of the Tenant Owner is not determinate for this program, a “good” rating or the ability to provide explanations for negative items will be helpful. Please provide some background information on the Business History and Activities of the Tenant Owner:

8. Name of Person providing this information:

If your business is pre-qualified, a further extensive application form will be required by the potential Lender. If the Lender approves and issues a Commitment, you will need to provide documented substantiation. Click Here to see a list of what is typically required. Financing is provided by third party lenders.

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