Please review your selections. If you need to make changes, click the Previous button at the bottom of the page to return to the form edit page.
DO NOT click the browser's Back button.
When done, you can print the form using your browser's Print button (or Ctrl P). If you are mailing us the form, send it to Shepherd’s Finance, LLC, 12627 San Jose Blvd., Suite 203, Jacksonville, FL 32223. If you are sending us the contents online, then click the Submit button at the bottom of the page. We will call you for your secure information once we review your Agreement.
INVESTMENT AMOUNT: {$15049032 Investment Amount}
INVESTMENT TERM: {$15049061 Investment Term}
PAYMENT METHOD: {$15191662 Payment Method}
CHOOSE ONE TYPE OF OWNERSHIP: {$15050345 Choose One Type of Ownership:}
INVESTOR: {$15191728 Investor} (first name): {$15191728-first Investor} (last name): {$15191728-last Investor}
CO-INVESTOR (joint only): {$15191730 Co-Investor} (first name): {$15191730-first Co-Investor} (last name): {$15191730-last Co-Investor}
FORMATION DATE: (S-Corp, C-Corp, LLC, Trust only): {$15191767 Formation Date}
RESIDENCE ADDRESS: {$15191747 Residence Address (no P...nts of NY not eligible)}
OPTIONAL MAILING ADDRESS: {$15191785 Optional Mailing Address (may be a P.O. Box)}
PRIMARY PHONE: {$15191792 Primary Phone}
SECONDARY PHONE: {$15191794 Secondary Phone}
ALTERNATIVE CONTACT: {$15191799 Alternative Contact}
ALTERNATIVE CONTACT PHONE: {$15191801 Alternative Contact Phone}
TRUSTEE (if Trust): {$15191812 Trustee}
CUSTODIAN (if Custodial Ownership): {$15191820 Custodian}
CUSTODIAN ACCOUNT NO.: {$15192654 Custodian Acct #}
CUSTODIAN ADDRESS: {$15191899 Custodian Address}
CUSTODIAN PHONE: {$15192655 Custodian Phone}
ELECTRONIC DOCUMENT AUTHORIZATION: {$15206242 Electronic Document Authorization}
EMAIL: {$15191876 Email}
NON-CUSTODIAL ACCOUNT PAYMENT OPTION: {$15191925 Non-Custodial Account Payment Option - Select One:}
CUSTODIAL ACCOUNT PAYMENT OPTION: {$15192366 Custodial Account Payment Option - Select One:}
MAIL MY CHECK TO THIS ADDRESS: {$15192177 Mail My Check to this Address:}
CHARITABLE DONATION MATCH: {$15193963 Charitable Donation Match}
% TO DONATE: {$15193977 Donate %}
CHARITY NAME: {$15194067 Charity Name}
CHARITY PHONE: {$15194068 Charity Phone}
ACKNOWLEDGEMENTS:
My Investment is Not Liquid: {$15194412 Investor - My Investment is Not Liquid}
Have Read the Prospectus: {$15207037 Have Read the Prospectus}
No FDIC Insurance: {$15207036 No FDIC Insurance}
Co-Investor - My Investment is Not Liquid: {$15194432 Co-Investor - My Investment is Not Liquid}
Co-Investor - Have Read the Prospectus: {$15207053 Co-Investor - Have Read the Prospectus}
Co-Investor - No FDIC Insurance: {$15207052 Co-Investor - No FDIC Insurance}
Investor Signature: {$15194622 Investor Signature}
Investor Signature Date: {$15206458 Investor Date}
PRINT SUBMISSION INVESTOR SIGNATURE/DATE
If you print and mail us this form, please sign and date below:
____________________________________________________________
Co-Investor Signature: {$15194663 Co-Investor Signature}
Co-Investor Signature Date: {$15206459 Co-Investor Date}
PRINT SUBMISSION CO-INVESTOR SIGNATURE/DATE
If you print and mail us this form, please sign and date below:
____________________________________________________________
{$17075155 ACH Agreement}
{$17077266 Alaska}
{$17077138 California}
{$17077154 Idaho}
{$17077165 Kansas}
{$17077171 Oregon}
Thank you very much!
Please review your selections. If you need to make changes, click the Previous button at the bottom of the page to return to the form edit page.
DO NOT click the browser's Back button.
When done, you can print the form using your browser's Print button (or Ctrl P). If you are mailing us the form, send it to Shepherd’s Finance, LLC, 12627 San Jose Blvd., Suite 203, Jacksonville, FL 32223. If you are sending us the contents online, then click the Submit button at the bottom of the page. We will call you for your secure information once we review your Agreement.
INVESTMENT AMOUNT: {$15049032 Investment Amount}
INVESTMENT TERM: {$15049061 Investment Term}
PAYMENT METHOD: {$15191662 Payment Method}
CHOOSE ONE TYPE OF OWNERSHIP: {$15050345 Choose One Type of Ownership:}
INVESTOR: {$15191728 Investor} (first name): {$15191728-first Investor} (last name): {$15191728-last Investor}
CO-INVESTOR (joint only): {$15191730 Co-Investor} (first name): {$15191730-first Co-Investor} (last name): {$15191730-last Co-Investor}
FORMATION DATE: (S-Corp, C-Corp, LLC, Trust only): {$15191767 Formation Date}
RESIDENCE ADDRESS: {$15191747 Residence Address (no P...nts of NY not eligible)}
OPTIONAL MAILING ADDRESS: {$15191785 Optional Mailing Address (may be a P.O. Box)}
PRIMARY PHONE: {$15191792 Primary Phone}
SECONDARY PHONE: {$15191794 Secondary Phone}
ALTERNATIVE CONTACT: {$15191799 Alternative Contact}
ALTERNATIVE CONTACT PHONE: {$15191801 Alternative Contact Phone}
TRUSTEE (if Trust): {$15191812 Trustee}
CUSTODIAN (if Custodial Ownership): {$15191820 Custodian}
CUSTODIAN ACCOUNT NO.: {$15192654 Custodian Acct #}
CUSTODIAN ADDRESS: {$15191899 Custodian Address}
CUSTODIAN PHONE: {$15192655 Custodian Phone}
ELECTRONIC DOCUMENT AUTHORIZATION: {$15206242 Electronic Document Authorization}
EMAIL: {$15191876 Email}
NON-CUSTODIAL ACCOUNT PAYMENT OPTION: {$15191925 Non-Custodial Account Payment Option - Select One:}
CUSTODIAL ACCOUNT PAYMENT OPTION: {$15192366 Custodial Account Payment Option - Select One:}
MAIL MY CHECK TO THIS ADDRESS: {$15192177 Mail My Check to this Address:}
CHARITABLE DONATION MATCH: {$15193963 Charitable Donation Match}
% TO DONATE: {$15193977 Donate %}
CHARITY NAME: {$15194067 Charity Name}
CHARITY PHONE: {$15194068 Charity Phone}
ACKNOWLEDGEMENTS:
My Investment is Not Liquid: {$15194412 Investor - My Investment is Not Liquid}
Have Read the Prospectus: {$15207037 Have Read the Prospectus}
No FDIC Insurance: {$15207036 No FDIC Insurance}
Co-Investor - My Investment is Not Liquid: {$15194432 Co-Investor - My Investment is Not Liquid}
Co-Investor - Have Read the Prospectus: {$15207053 Co-Investor - Have Read the Prospectus}
Co-Investor - No FDIC Insurance: {$15207052 Co-Investor - No FDIC Insurance}
Investor Signature: {$15194622 Investor Signature}
Investor Signature Date: {$15206458 Investor Date}
PRINT SUBMISSION INVESTOR SIGNATURE/DATE
If you print and mail us this form, please sign and date below:
____________________________________________________________
Co-Investor Signature: {$15194663 Co-Investor Signature}
Co-Investor Signature Date: {$15206459 Co-Investor Date}
PRINT SUBMISSION CO-INVESTOR SIGNATURE/DATE
If you print and mail us this form, please sign and date below:
____________________________________________________________
{$17075155 ACH Agreement}
{$17077266 Alaska}
{$17077138 California}
{$17077154 Idaho}
{$17077165 Kansas}
{$17077171 Oregon}
Thank you very much!