First & Last Name*

Email*

Contact Phone*

Are You the Owner/Seller of the Note?*
YesNo

Have You Received Offers on this Note Before?*
YesNo

Note Information

Original Loan Amount of the Note(Not the sales price)*

Interest Rate*

Monthly Payment Amount*

Term of the Loan in Months or Years - (Amortization Period)*

Is this a 1st or 2nd Position Loan?*
First PositionSecond Position

Date You Received 1st Monthly Payment*

Day of the Month Payment is Due*

Are Monthly Payments on Time?*
YesNo

Is There a Balloon Payment?*
YesNo

Date Balloon Payment is Due*

PROPERTY INFORMATION

Date Property Sold*

Sale Price of the Property Sold*

Down Payment Buyers Paid*

Are Buyers Living in the Property Sold?*
YesNoRental

How Long Did You Own the Property Before Selling It?*
More Than a YearLess Than a YearInheritance

Type of Property Sold*
Single Family ResidenceCommercial BuildingCondoApartment BuildingMobile HomeVacant Land

Property Address*

OTHER INFORMATION

Buyer/Payer's Credit Score (If Known)*

If Unknown - What do Buyers/Payers do for a Living?*

Comments You Believe Will Enhance Note or Property Sold*