First Name:

Last Name:

Email:

Phone Number:

Why are you selling your Note:

Is the note current:

Yes No

If not how many month behind:

Payor type:

Individual Corp.LLC Trust

Guarantor type:

Individual Corporation LLC Other

Credit Score of Payor:

Credit Score of Guarantor:

Specific Use Purpose of Land:

Number of rental units:

Owner Occupancy Percentage:

Total Occupancy Percentage:

Appraised Value of Property:

Date of Appraisal:

Date of Sale:

Sale Price:

Down Payment:

Original Note Amount:

Interest Rate of Note:

Payment Amount:

Length of Loan:

Balloon Payment:

Yes No

Due Date of Balloon:

Lien Position:

First Second Third

Total Monthly Rental Income: