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Your Name * Phone Number E-Mail Address * I am the * Choose One Note Holder Broker Property Address * City * State * Choose One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code * Type of Property * Choose One Single Family Home Multi-Family Home Townhome Mobile Home Condo Commercial Land Is the property occupied? * Choose One Yes No Property Value * Sale Price * Sale Date * 1st Loan - Amount * 1st Loan - Monthly Payment * 1st Loan - New or Assumed * Choose One New Assumed None 2nd Loan - Amount * 2nd Loan - Monthly Payment * 2nd Loan - New or Assumed * Choose One New Assumed None Down Payment * Loan to Value * Original Note Amount * Position of Note * Choose One 1st 2nd 1st Remaining Balance * 2nd Remaining Balance * Current Balance * As of Date * Interest Rate * Payment Amount * Date of First Payment * Original Note Length * Type of Note * Choose One Amortized Interest Only Payor Name * Payor Credit Score * Payor Date of Birth * Number of Payments Made * Number of Payments Remaining * Are Payments on Time? * Choose One Yes No What day of the month are payments due? * Next Payment Due Date * Are the payments Current or Delinquent * CurrentDelinquent Is there a Balloon Payment? * Choose One Yes No How much is the Balloon Payment? When is the Balloon Payment due? Are there any clauses? * Choose One Yes No If yes, what are they? How did you find out about us? * Choose One Newspaper Friend Flyers Google MSN Web Other Have you ever sold a note before? * Choose One Yes No Have you received other offers to buy your note? * Choose One Yes No How motivated are you to sell your note? * Choose One Very Motivated Motivated Not Very Motivated How soon do you want to close? * Choose One Very Soon Soon No Hurry Any additional information about your Real Estate Note:
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