PA C-PACE Pre-Application Form

Street Address*

Street Address City State ZIP Code

Ownership Name*

Property Sq. Ft.*

County*

Parcel Tax ID Number*

Property Delinquencies:

Have no notices of default or delinquency on property-based debt that have been recorded and not cured.
No mortgage delinquency, current on all payments on property
County/muni taxes or fees, judgements, or defaults on the property?

Property Type*

Mortgage Lender Name*

Property Value*

Estimated Mortgage Balance*

Source of Value (appraisal, recent sale, assessment, etc.)*

Has obtained lender consent?*