First Name:  *

Last Name:  *

Your Time Zone:  *

Best time to call you back with a quote:  *

(Area Code) Phone Number:  *

Email Address:  *

Your City:  *

State: Select One:AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington D.C.West VirginiaWisconsinWyoming

Zip Code:

Property Information:

Property Type: Residential Lot UrbanRes. Lot RuralRes. Lot Water FrontRes. AcreageRes. Acreage Water FrontRecreationalFarmMobile Home ParcelUnimproved Land

Fully describe the property & improvements:  *

What is the best use for the property:  *

Property address:  *

City:  *

State: Select One:AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWashington D.C.West VirginiaWisconsinWyoming

Zip Code:  *

Property County:  *

Note Payors Information:

Note payors name:  *

Note payors address:  *

Note payors credit believed to be: A - ExcellentB - GoodC - Below AverageD - Poor

Receivable Information

Receivable Type: Note & MortgageNote & Deed of TrustLand ContractContract for DeedOther

If other please specifiy:

Note lien position: 1st2ndAll-Inclusive Wrap

Note Status: Current Delinquent

Date of sale:  *

Sale Price:  *

Down Payment:  *

Beginning Balance (1st Lien):  *

Beginning Balance (2nd Lien):

Date 1st payment was due:  *

Next payment due date:  *

Payment amount:  *

Term of note (in months):  *

Payment frequency: MonthlyQuarterlySemi-AnnualAnnualOther

Interest rate:  *

Current balance (1st Lien):  *

Current balance (2nd Lien):

Number of payments made:  *

Number of payments remaining:  *

Is there a balloon payment? Yes No

Balloon payment due date:

Amount of balloon payment:

What is the approximate value of the property?  *

Special Clauses or Comments:

List amounts of any junior position (2nd or 3rd) liens:

Reason for selling your note:  *

What type of purchase are you interested in? Full purchasePartial purchase

Is there a specific dollar amount you need to raise?  *

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

Note and Deed of Trust Mortgage or Contract: Yes No

Escrow Closing Statement: YesNo

Payment History: Yes No

Title Insurance Policy: Yes No

Recent appraisal of the property? YesNo

Current Hazard Insurance Policy: YesNo

Can you provide a photo of the property? YesNo

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