Background Authorization

Thank you for taking the time to provide these details in connection with your Double Backflip, LLC Loan Application!

Background Authorization Form

"*" indicates required fields

Please confirm the property details

Property Address of The Deal*

Not your personal or mailing address.

Street Address Address Line 2 City State ZIP Code

Please provide your individual details

Your Name*

Please ensure this matches your legal name on your Government Issued ID

First Middle Last

Your Current Mailing Address

Ensure this is your mailing address where it will be best to send any physical correspondence

Street Address Address Line 2 City State ZIP Code

Social Security Number (SSN)*

Date of Birth*

Marital Status*

Spouse's Name

If applicable

First Last

Please confirm your citizenship status*

Please answer a few quick questions in regards to your background

Are you aware of any outstanding judgements against you?*

Are you currently delinquent or in any default on any federal debt or any other loan, mortgage, financial obligation, bond, or loan guarantee?*

Do you have any active lawsuits against you?*

Do you currently have or previously had any property tax liens?*

Are you currently charged with or have you ever been convicted of a felony or other fraud related crimes?*

Have you declared bankruptcy within the past 7 years?*

Have you directly or indirectly been obligated to any loan which resulted in foreclosure, transfer of title in lieu of foreclosure, or judgement?*

Please provde more details on the above items that you selected "yes" on