Genaral Information
Name
*
First Name
Last Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Are You the Owner/Seller of the Note?
Yes
No
Are You the Owner/Seller of the Note?
Yes
No
NOTE INFORMATION
Original Loan Amount of the Note
Interest Rate
Monthly Payment Amount
Is this a 1st or 2nd Position Loan?
First Position
Second Position
Term of the Loan in Months or Years - (Amortization Period)
Date You Received 1st Monthly Payment
Day of the Month Payment is Due
Are Monthly Payments on Time?
Yes
No
Is There a Balloon Payment?
Yes
No
PROPERTY INFORMATION
Date Property Sold
Sale Price of the Property Sold
Are Buyers Living in the Property Sold?
Yes
No
How Long Did You Own the Property Before Selling It?
More Than a Year
Less Than a Year
Inheritance
Type of Property Sold
Single Family Residence
Commercial Building
Condo
Apartment Building
Mobile Home
Vacant Land
Property Address
Street Address
Street Address
City
Zip
OTHER INFORMATION
Buyer/Payer's Credit Score (If Known)
What do Buyers/Payers do for a Living?
Comments You Believe Will Enhance Note or Property Sold
Submit
Should be Empty: