Construction Loan Request

Date:

Borrower Information Guarantor Names:

Borrower Occupation:

Address:

City, State, Zip

Email:

Phone:

Project InformationProject Address:

City, State, Zip:

Date Land Purchased:

Purchase Price of land:

Amount Owed on land:

Future Value:

Estimated Completion Cost:

Estimated Completion Time:

Building Square Feet:

Project Description:

Broker InformationBroker Name:

Company:

Email:

Phone:

Provident Bank Mortgage Account Executive or Commercial Loan Officer:

For Provident Bank Letter of Interest Please submit the following: (check box if included in package)

Complete Construction Loan Application

Complete Cost Breakdown

Copy of Credit (if available)

Contractor / Builder / Developer Information

Construction Loan Package Checklist: This list details all items needed to order appraisal and proceeding with full underwriting. Please click here: http://www.myprovident.com/commercialdocs.asp (See Construction Section)

Borrower Approx. Net Worth (Reserves+RE Equity)

Noteworthy Credit information such as: foreclosures, loan modification, Bankruptcy, short sales? Please explain:

Number of Units to be built

City, State, Zip

License Number:

Contractor Information:Contractor Name:

Business Phone:

Cell Phone:

Fax Number:

Contractor Address:

City, State & Zip:

Contractor Email:

Project Manager:

Provident Bank / www.myprovident.com / Toll Free Phone: 866-781-1142

Provident Savings Bank, F.S.B., NMLS# 449980

Please complete all fields

Address:

Vesting Name: