Note Application
CONTACT INFORMATION
Name
*
First Name
Last Name
Phone
*
-
Area Code
Phone Number
E-mail
*
Title:
*
Please Select
Note Owner/Note Holder
Note Broker
Real Estate Broker/Agent
Mortgage Banker/Broker
Attorney
Executor of Estate
Trustee
Financial Planner
CPA
Other
Company Name
SALE INFORMATION
Date of Sale
*
Sale Price $
*
Down Payment $
*
Do You Have Title Policy?
*
Yes
No
Unknown
Did You Use an Attorney or Title Company to Close?
*
Yes
No
Unknown
SOLD PROPERTY INFORMATION
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Property Value $
*
Property Type
*
Single Family
Town Home
Condo
Multi-Family (Duplex/Quadplex,etc)
Commercial
Mobile Home with Land
Bare Land (No building or structure on property)
When Was Value Established?
*
How Was Value Established?
*
Property Sale
Appraisal
BPO (Broker Pricing Opinion)
Tax Assessor Office
Realtor
Speculation
Other
Unknown
Any Other Liens on Property?
*
Yes
No
Is Property Owner Occupied?
*
Yes
No
Unknown
Land Plot Size
Square Footage of Building
Other Property Details
NOTE INFORMATION
Original Note Amount $
*
Position of Note
*
1st
2nd
Wrap-Around 2
3rd
Other
Note Balance $
*
Interest Rate %
*
Payment Amount $
*
Payment Frequency
*
BI-Weekly
Monthly
Quarterly
Semi-Annually
Annually
One-Time Ballon Payment
Date of 1st Payment
*
Original Length
*
No. of Payments Made
*
No. of Payments Remaining
*
Date of Next Payment
*
Are the Payments on Time
*
Yes
No
Balloon Amount
Balloon Due Date
BORROWER INFORMATION
Borrower Type
*
Private Individual(s)
Corporate Entity (INC, LLC, etc.)
Government Entity
Trust
Other
Borrower(s) Name
Did You Pull a Credit Report at Sale
*
Yes
No
Unknown
Borrower Credit Rating
*
850 - 801 (Perfect)
800 - 751 (Excellent)
750 - 701 (Great)
700 - 651 (Good)
600 - 551 (Poor)
550 or Lower (Extremely Poor)
Did not pull a credit report
Unknown
Is there a Personal Guarantee
Yes
No
Not Applicable
Unknown
Borrower Employment
Additional Information
I hereby agree that the information given is true, accurate and complete as of the date of this application submission. *
*
YES
Send Application Now
Should be Empty: