Secure Intake Structured Review

Detailed, lender-ready intake workflow

Complete the official DOMINANT Capital intake form in a responsive digital flow designed for faster prequalification, cleaner underwriting inputs and fewer back-and-forth gaps.

Complete Intake Need Help First?

01 Secured Intake

Answer each field clearly so Dominant can review the opportunity faster.

This responsive digital intake follows the official secured prequal form structure, but in a cleaner, mobile-friendly layout that saves directly into the WordPress admin for your team.

Please answer all relevant questions electronically. Incomplete or duplicate requests can delay review, and you can save a draft anytime if you need to pause before submitting.

Draft Save & Resume

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Save your progress in the middle and continue later without starting over.

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Loan Request & Purpose

Start with the financing target, term expectations and the exact use of capital.

Loan Request

Term Request

Purpose of Loan

If refinance, current mortgage balance and lender name

Itemized use of funds, debts to be paid off, etc.

Project summary and special issues, problems, needs and/or deadlines

Exit strategy

Subject Property

Give the exact asset profile, value story and occupancy details tied to this financing request.

Subject Property Address

City

State

ZIP

Property Type

Number of Units

Year Built

Purchase Price

Date Purchased

Current As-Is Market Value

As-Complete After Repair Value

If purchase, liquid cash invested

Rehab Amount

Total personal liquid cash investment to date

If leased, total monthly rent roll

Foreclosure / deed in lieu in last 7 years?

Primary residence?

Appraisal completed?

If yes, appraisal date

Subject property occupancy

Borrower

Complete the primary owner or partner information exactly as it should appear for review.

First Name

Middle Name

Last Name

Cell Phone

Home Phone

Address

City

State

ZIP

FICO (all 3 bureaus)

SS#

Date of Birth

Mortgages current, late or in default?

US Citizen?

Permanent resident alien?

Outstanding judgments?

Declared bankruptcy in past 7 years?

If yes, when?

Party to a lawsuit?

Obligated on a loan that resulted in foreclosure / deed in lieu / judgment?

Delinquent or in default on federal debt / other obligation?

Co-Borrower

Optional unless another owner, partner, spouse or guarantor needs to be included.

First Name

Middle Name

Last Name

Cell Phone

Home Phone

Address

City

State

ZIP

FICO

SS#

Date of Birth

Mortgages current, late or in default?

US Citizen?

Permanent resident alien?

Outstanding judgments?

Declared bankruptcy in past 7 years?

If yes, when?

Party to a lawsuit?

Obligated on a loan that resulted in foreclosure / deed in lieu / judgment?

Delinquent or in default on federal debt / other obligation?

Financial Snapshot

Provide the combined borrower and co-borrower asset picture requested in the original form.

Total Cash on Hand and In Banks

Total in Savings Accounts

IRA, 401K, Retirement or Other

Accounts & Notes Receivable

Life Insurance - Cash Surrender Value

Stocks & Bonds

Real Estate

Automobiles

Other Personal Owned Property

Other Personal or Business Assets

Experience & Notes

Help the team understand your execution history, current portfolio and special deal context.

How many properties have you purchased, rehabbed and/or sold in the last 36 months?

How many investment properties do you currently own 100%? Are they vacant or tenanted and cashflowing?

Notes, history, comments, additional details, special requests, issues, concerns, deadlines or questions

Certification & Sign-Off

Type the names exactly as they should be associated with this submission and confirm the date.

By submitting this intake, you confirm that the information supplied is true and complete to the best of your knowledge, that no material information has been omitted, and that Dominant may review the request and route it through the proper lending review workflow.

Borrower Typed Signature Name

Borrower Signature Date

Co-Borrower Typed Signature Name

Co-Borrower Signature Date

Every approved submission is stored securely in the admin and sent to the intake review queue.