Dominion Financial Quotation Form

Step 1 of 4

Program (Choose One)(Required)

Portfolio Loan (please attach data tape & complete Section I only)

Single Location/Buy/Hold Loan

Basic Fix/Flip (Cosmetic Only)

*Structural/Builders Risk Flip/Flip (Adding square footage or removing structural components)

*New/Ground Up Construction

Project/Location Address(Required)

Street Address Address Line 2 City State ZIP Code

Existing Living Area SF(Required)

Proposed Living Area SF(Required)

Type of Dwelling(Required)

Type of Construction(Required)

If Other, Please Specify(Required)

Year Built(Required)

Estimated Closing Date(Required)

Minimum Dwelling Amount Required(Required)

Loan Number(Required)

Loan Amount(Required)

Loan Representative Email(Required)

Is this property in a Flood Zone & is Flood Insurance required?(Required)

Yes

If you answered yes, please specify flood zone below