{"id":342,"date":"2024-08-05T16:48:04","date_gmt":"2024-08-05T14:48:04","guid":{"rendered":"https:\/\/pncprivatecapital.net\/?page_id=342"},"modified":"2024-11-11T23:09:02","modified_gmt":"2024-11-11T22:09:02","slug":"submission-form","status":"publish","type":"page","link":"https:\/\/pncprivatecapital.net\/index.php\/submission-form\/","title":{"rendered":"SUBMISSION FORM"},"content":{"rendered":"<div class=\"flex\">\n<div class=\"logof\">\n<img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/pncprivatecapital.net\/wp-content\/uploads\/2024\/01\/lopago.png\" alt=\"\" width=\"1598\" height=\"587\" class=\"alignnone size-full wp-image-345\" \/>\n    <\/div>\n<div>\n<h2 class=\"titulof\">FLORIDA LOAN<\/br>SUBMISSION FORM<\/h2>\n<\/p><\/div>\n<\/div>\n<form name=\"submission\" id=\"formulario1\">\n<div class=\"flex\">\n<div>\n<p>Please send submission form and documents to:<br \/>\n       Pedro Nivela | info@pncprivatecapiotal.net| 305-968-9407<\/p>\n<\/p><\/div>\n<div>\n<p> Submission Date:<input type=\"date\" name=\"fecha\" class=\"fechaf\" id='fechabase' disabled\/><\/p>\n<\/p><\/div>\n<\/div>\n<hr>\n<h3 class=\"titulof\">BORROWER INFORMATION<\/h3>\n<div class=\"formb\">\n   <label for=\"borrowerName\">Borrower Name<\/label><br \/>\n   <input type=\"text\" id=\"borrowerName\" name=\"nameborrower\" placeholder=\"Borrower Name...\"  class=\"inputf\" alt=\"0\"\/><\/p>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"guarantorname\">Guarantor Name<\/label><br \/>\n        <input type=\"text\" id=\"guarantorname\" name=\"nameguarantor\"  class=\"inputf\" placeholder=\"Guarantor Name...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"guarantoremail\">Guarantor Email<\/label><br \/>\n        <input type=\"email\" id=\"guarantoremail\" name=\"emailguarantor\" class=\"inputf\" placeholder=\"Guarantor Email...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"guarantorphone\">Guarantor Phone<\/label><br \/>\n        <input type=\"text\" id=\"guarantorphone\" name=\"phoneguarantor\" maxlength=\"14\" class=\"inputf\" placeholder=\"Guarantor Phone...\" onfocus=\"eva(this,0)\" onfocusout=\"eva(this,0)\"  onkeydown=\"evaluatel([event,this,0])\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"guarantorname\">Guarantor Name<\/label><br \/>\n        <input type=\"text\" id=\"guarantorname1\" name=\"nameguarantor1\"  class=\"inputf\" placeholder=\"Guarantor Name...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"guarantoremail\">Guarantor Email<\/label><br \/>\n        <input type=\"email\" id=\"guarantoremail1\" name=\"emailguarantor1\" class=\"inputf\" placeholder=\"Guarantor Email...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"guarantorphone\">Guarantor Phone<\/label><br \/>\n        <input type=\"text\" id=\"guarantorphone1\" name=\"phoneguarantor1\" maxlength=\"14\" class=\"inputf\" placeholder=\"Guarantor Phone...\" onfocus=\"eva(this,0)\" onfocusout=\"eva(this,0)\"  onkeydown=\"evaluatel([event,this,0])\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"propertytype\">Property Type <b>(Requested)<\/b><\/label><br \/>\n        <select name=\"propertytype\" id=\"propertytype\"  class=\"inputf quested\" alt=\"1\" value=\" \"><option value=\" \" selected>(select)<\/option><option value=\"Residential\">Residential<\/option><option value=\"Commercial\">Commercial<\/option><option value=\"Land\">Land<\/option><option value=\"Rehab\">Rehab<\/option><option value=\"Construction\">Construction<\/option><option value=\"Other\">Other (specify here)<\/option><\/select>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"association\">Is the property managed by a Homeowners Association?<\/label><br \/>\n         <select name=\"association\" id=\"association\"  class=\"inputf\" alt=\"0\"><option value=\"select\">(select)<\/option><option value=\"si\">Yes<\/option><option value=\"no\">No<\/option><\/select>\n      <\/div>\n<\/p><\/div>\n<div>\n     <label for=\"streetaddress\">Property Street Address <b>(Requested)<\/b><\/label><br \/>\n     <input type=\"text\" id=\"streetaddress\" name=\"streetaddress\" placeholder=\"Property Street Address...\"  class=\"inputf quested\" alt=\"1\"\/>\n    <\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"city\">City <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"text\" id=\"city\" name=\"city\"  class=\"inputf quested\" placeholder=\"City...\" alt=\"1\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"State\">State <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"text\" id=\"State\" name=\"State\" class=\"inputf quested\" placeholder=\"State...\" alt=\"1\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"zipcode\">Zip Code <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"text\" id=\"zipcode\" name=\"zipcode\" class=\"inputf quested\" placeholder=\"Zip Code...\" alt=\"1\"\/>\n      <\/div>\n<\/p><\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"purchaseprice\">Purchase Price<\/label><br \/>\n        <input type=\"text\" id=\"purchaseprice\" name=\"purchaseprice\" min=\"0\"  class=\"inputf\" placeholder=\"Purchase Price...\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"refinancevalue\">Refinance Value<\/label><br \/>\n        <input type=\"text\" id=\"refinancevalue\" name=\"refinancevalue\" class=\"inputf\" placeholder=\"Refinance Value...\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"Mortgage\">Mortgage Payoff Amount<\/label><br \/>\n        <input type=\"text\" id=\"Mortgage\" name=\"Mortgage\" class=\"inputf\" placeholder=\"Mortgage Payoff Amount...\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"Request\">Loan Request<\/label><br \/>\n        <input type=\"text\" id=\"Request\" name=\"Request\" class=\"inputf \" placeholder=\"Loan Request...\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"LTV\">LTV\/CLTV<\/label><br \/>\n        <input type=\"text\" id=\"LTV\" name=\"LTV\"  class=\"inputf\" placeholder=\"LTV\/CLTV...\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"refinancevalue\">Blanket Loan<\/label><br \/>\n        <select name=\"refinancevalue\" id=\"refinancevalue\"  class=\"inputf\" alt=\"0\"><option value=\"select\">(select)<\/option><option value=\"si\">Yes<\/option><option value=\"no\">No<\/option><\/select>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"Mortgage\">Occupancy<\/label><br \/>\n         <select name=\"Mortgage\" id=\"Mortgage\"  class=\"inputf\" alt=\"0\"><option value=\"select\">(select)<\/option><option value=\"Primary\">Primary<\/option><option value=\"Investor\">Investor<\/option><\/select>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"Request\">Close Date<\/label><br \/>\n        <input type=\"date\" id=\"Request\" name=\"closedate\" class=\"inputf\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<div>\n<div class=\"formb nobottom\">\n<h3 class=\"titulof\">BROKER INFORMATION<\/h3>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"brokercompany\">Broker Company <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"text\" id=\"brokercompany\" name=\"brokercompany\"  class=\"inputf quested\" placeholder=\"Broker Company...\" alt=\"1\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"prokerpoints\">Broker Points<\/label><br \/>\n        <input type=\"text\" id=\"prokerpoints\" name=\"prokerpoints\" class=\"inputf\" maxlength=\"3\" style=\"width: 60px; margin-left: 5px;\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" \/><input type=\"text\" id=\"prokerpoints1\" name=\"prokerpoints1\" class=\"inputf\" maxlength=\"3\" style=\"width: 60px; margin-left: 5px;\" onfocus=\"eva(this,1)\" onfocusout=\"eva(this,1)\" onkeydown=\"evaluanum([event,this,1])\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"MLOName\">MLO Name <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"text\" id=\"MLOName\" name=\"MLOName\"  class=\"inputf quested\" placeholder=\"MLO Name...\" alt=\"1\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"MLOPhone\">MLO Phone <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"text\" id=\"MLOPhone\" name=\"MLOPhone\" class=\"inputf quested\" placeholder=\"MLO Phone...\" maxlength=\"14\" onfocus=\"eva(this,0)\" onfocusout=\"eva(this,0)\"  onkeydown=\"evaluatel([event,this,0])\" alt=\"1\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"MLOEmail\">MLO Email <b>(Requested)<\/b><\/label><br \/>\n        <input type=\"email\" id=\"MLOEmail\" name=\"MLOEmail\" class=\"inputf quested\" placeholder=\"MLO Email...\" alt=\"1\" data-toggle=\"tooltip\" title=\"Requested\"\/>\n      <\/div>\n<\/p><\/div>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"ProcessorName\">Processor Name<\/label><br \/>\n        <input type=\"text\" id=\"ProcessorName\" name=\"ProcessorName\"  class=\"inputf\" placeholder=\"Processor Name...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"ProcessorPhone\">Processor Phone<\/label><br \/>\n        <input type=\"text\" id=\"ProcessorPhone\" name=\"ProcessorPhone\" class=\"inputf\" maxlength=\"14\" placeholder=\"Processor Phone...\" onfocus=\"eva(this,0)\" onfocusout=\"eva(this,0)\"  onkeydown=\"evaluatel([event,this,0])\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"ProcessorEmail\">Processor Email<\/label><br \/>\n        <input type=\"email\" id=\"ProcessorEmail\" name=\"ProcessorEmail\" class=\"inputf\" placeholder=\"Processor Email...\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<h3 class=\"titulof\">TITLE AGENT FOR PURCHASES (Benworth appoints the title agent for refinance transactions)<\/h3>\n<div class=\"flex\">\n<div class=\"itemf\">\n        <label for=\"TitleAgentName\">Title Agent Name<\/label><br \/>\n        <input type=\"text\" id=\"TitleAgentName\" name=\"TitleAgentName\"  class=\"inputf\" placeholder=\"Title Agent Name...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n        <label for=\"TitleAgentPhone\">Title Agent Phone<\/label><br \/>\n        <input type=\"text\" id=\"TitleAgentPhone\" name=\"TitleAgentPhone\" class=\"inputf\" onfocus=\"eva(this,0)\" maxlength=\"14\" onfocusout=\"eva(this,0)\"  onkeydown=\"evaluatel([event,this,0])\" placeholder=\"Title Agent Phone...\" alt=\"0\"\/>\n      <\/div>\n<div class=\"itemf\">\n         <label for=\"TitleAgentEmail\">Title Agent Email<\/label><br \/>\n        <input type=\"email\" id=\"TitleAgentEmail\" name=\"TitleAgentEmail\" class=\"inputf\" placeholder=\"Title Agent Email...\" alt=\"0\"\/>\n      <\/div>\n<\/p><\/div>\n<p>    <button type=\"button\" class=\"btn\" onclick=\"limpia()\"><i class=\"fa fa-trash icof\" aria-hidden=\"true\"><\/i>Clear Form<\/button><button type=\"button\" class=\"btn\" onclick=\"enviar()\"><i class=\"fa fa-envelope icof\" aria-hidden=\"true\"><\/i>Send<\/button>\n<\/div>\n<\/form>\n<div id=\"alerta\" class=\"alerta\">\n<div class=\"aincon\"><i class=\"fa fa-hand-o-down\" aria-hidden=\"true\"><\/i><button type=\"button\" class=\"btn\" style=\"position: absolute;top: 0;right: 0;margin: 0;padding: 5px 10px;\"><i class=\"fa fa-window-close-o\" aria-hidden=\"true\"><\/i>Close<\/button><\/div>\n<div class=\"altext\">Por Favor complete todos los Campos<\/div>\n<div>\n<div class=\"aincon\" style=\"display:none;\"><i class=\"fa fa-exclamation-triangle\" aria-hidden=\"true\"><\/i><\/div>\n<div class=\"altext\" style=\"display:none;\"> A ocurrido error y no se a enviado el Formulario<\/div>\n<div class=\"aincon\" style=\"display:none;\" ><i class=\"fa fa-thumbs-o-up\" aria-hidden=\"true\"><\/i><\/div>\n<div class=\"altext\" style=\"display:none;\">Formulario enviado correctamente<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>FLORIDA LOANSUBMISSION FORM Please send submission form and documents to: Pedro Nivela | info@pncprivatecapiotal.net| 305-968-9407 Submission Date: BORROWER INFORMATION Borrower Name Guarantor<\/p>\n<p class=\"link-more\"><a class=\"myButt \" href=\"https:\/\/pncprivatecapital.net\/index.php\/submission-form\/\">Read More<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"formulario.php","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/pages\/342"}],"collection":[{"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/comments?post=342"}],"version-history":[{"count":154,"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/pages\/342\/revisions"}],"predecessor-version":[{"id":536,"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/pages\/342\/revisions\/536"}],"wp:attachment":[{"href":"https:\/\/pncprivatecapital.net\/index.php\/wp-json\/wp\/v2\/media?parent=342"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}