1. Property, No................... St., Ave., Pl., City of ................

State of .............. Population of City ........

2. Amount wanted, $........, at ....%, for........years.

3. Full name of individual, corporation or firm, who will execute the Bond and Mortgage. If a corporation, give names of officers......................

4. (If a corporation) Amount of paid-up capital, $....... Surplus, $.......

Please draw accurate diagram of land and building giving exact dimensions and distance from nearest corner. Insert names of streets.

Please show on diagram location of other prominent buildings in vicinity.

Send photograph of building if possible.

5. Size of land........x........Size of Building (on ground)......x......

No. of stories high ..........

6. Year built..... If under construction, when will it be completed?........

7. State exact nature of construction. What portion of building is steel, reinforced concrete or brick ? ......................

8. Purposes of use ..........................

9. Describe interior arrangement. If an apartment house, give number of apartments on each floor and number of rooms in each apartment. If an office building, give number of offices on each floor. If stores, how many?

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10. Number of elevators: Passenger? ......Freight?......

11. How heated?........ How lighted?........

12. Total annual gross rent (when fully rented) $.......... Amount now rented......Total annual expenses, including taxes, but not including interest on mortgages, $..........

13. Nearest street railway line to this property............

14. Owner's value, Land $........ Building $........Total $..........

15. Assessed by City for, Land $.......Building $....... Total $........

On what percentage of value is the assessment fixed by Board of Assessors?....

16. Present mortgages on property

1$......, at........%, held by........, due......19..

$......, at.......%, held by......... due......19..

Will holders of above mortgages accept payment?......

17. Who will show property?..........Address..........

18. Business of borrower .....................

Name of applicant.............................

Address ........................................

Telephone number...............