Form Page: noteform

First Name:

Last Name:

Best time to call you back with a quote:

(Area code) Phone number:

Email Address:

Your Address:

State:

Zip:

PROPERTY INFORMATION

Property Type:

If mobile home what year was it manufactured:

If mobile home what is the make & model:

Type of mobile (Single or Double):

Property address:

City:

State:

Zip Code:

Property County:

Decribe Property & Area (Bed, Baths, Age, Size, Sq Ft, Lot Size, Zoning etc)

NOTE PAYOR INFORMATION

Note Payors Name:

Note Payors Address:

Employment Status:

Payors SS#

Receivable Type:

If other please specify:

Note lien position:

Is the property owner or tenant occupied:

Rent amounts if tenant occupied:

When Did You Acquire Title To The Property?

Acquisition Date:

Date of sale:

Sale price:

Down payment:

Beginning balance (1st lien):

Beginning balance (2nd lien):

Date 1st payment was due:

Date next payment is due:

Payment Amount:

Term of note (in months):

Payment frequency:

Interest rate:

Current balance (1st lien):

Current balance (2nd lien):

Number of payments made:

Number of payments remaining:

Is there a balloon payment:

Balloon payment due date:

Amount of balloon payment:

What is the approximate value of the property:

Special clauses or comments:

Reason for selling your note:

List amounts of any junior position liens:

What type of purchase are you interested in:

Cash Amount Desired:

Do you have and can you supply copies of the following documents:

Note Deed of Trust Mortgage or Contract:

Escrow closing statement (HUD-1):

Existing title insurance policy:

Recent appraisal of property:

Current hazard insurance policy:

Payment history:

Can you supply a photo of the property:

I am ready for a free quote and if your offer meets my approval I am ready to close this transaction within the next 30 days.

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