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Your
Information |
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The
person
completing this
form is:
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First
Name:
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Last
Name:
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Address
Street:
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Address Street
2 as
needed:
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City:
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Zip
Code:
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(5
digits) |
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State:
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Your
Contact
Information
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Daytime
Phone:
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Evening
Phone:
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Cell
Number:
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Fax Number:
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Email:
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Are you
personally
receiving
payments on
this note?
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Note
Information |
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Property Sales
Date:
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Sales Price
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Down Payment
Made
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Original amount
of the
Note:
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Current
Balance
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Term in
Months
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When was the
first payment
made on this
note?
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Next payment
due
date:
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Number of
payments
made:
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Number of
payments
remaining?
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Principal and
Interest
Payment
Amount:
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Interest
Rate:
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% |
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Lien
Position:
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If Wrap or AITD
indicate amount
of senior
lien:
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Instrument
Type
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Mortgage,
TD or land
contract |
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Is there a
Balloon?
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If yes, what is
the Balloon
payment
amount:
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Balloon payment
date:
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Are the note
payments
delinquent or
current:
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Property
Estimated
Value:
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Based on:
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Payor's credit
rating if
known?
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If there is a
2nd Note what
is the
Remaining
Balance?
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Property
Information |
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Location
State:
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Location
City:
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Location
County
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Property
Type:
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Owner
Occupied?:
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Marketing
Information |
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Please Tell us
how you found
us:
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engine, can you
tell us what
keywords you
used?
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Human Verification |
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