| Are The Note Payments Current (If "No", discontinue) |
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| Note Position |
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| Your Relationship to This Note |
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| Your Title |
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| Your First and Last Name |
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| Your E-mail Address |
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| Your Phone Number (Format: XXX XXX-XXXX) |
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| Your Alternate Phone Number (Format: XXX XXX-XXXX) |
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| Your Time Zone |
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| Your City |
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| Your State |
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| Is This a Full Sale or a Partial Sale |
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| Do You Have Additional Notes For Sale |
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| Does The Note Have Joint Payors |
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| Is There an Underlying Note |
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| Do You Need To Sell By a Specific Date |
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| If "Yes", Enter the Sales Deadline (M/D/Y) |
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| Payor's Current Employment Status |
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| Payor's Credit Rating is |
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| Payor's Credit (FICO) Score is |
(3 digits) |
| Estimated Property Value |
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| How Was The Value Determined (Realtor, Appraiser, etc.) |
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| Is There Any Money Owing On the Property (Taxes, Fines, etc.) |
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| If "Yes", Enter the Amount Owing |
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| Is The Property Owner-Occupied |
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| Sale Price of the Property |
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| Amount of the Down Payment |
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| What Type of Property is the Note On |
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| If "Other", Please Specify |
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| If Property is a Mobile Home, Enter Make / Model Number |
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| Current Number of Property Vacancies |
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| In Which City is the Property Located |
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| In Which State is the Property Located |
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| Term of Note (in months) |
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| Original Value of the Note |
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| Current Value of the Note |
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| Interest Rate Charged |
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| When Are the Payments Made |
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| Is There a Penalty For an Early Payoff |
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| Amount of Each Note Payment |
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| Number of Payments Already Made |
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| Number of Payments Remaining |
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| Number of Payments That Were Late |
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| Is a Fee Charged For Late Payments |
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| If "Yes", Enter the Amount of the Late Fee |
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| Original LTV Ratio |
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| Is a Balloon Payment Due |
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| If "Yes", Amount of Balloon Payment |
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| Enter Date of the Balloon Payment (M/D/Y) |
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| This Note is... |
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| Type of Current Lien |
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| Is There an AITD/Wrap Lien in Place |
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| 1st Lien Remaining Balance |
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| Interest Rate on 1st Lien |
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| 2nd Lien Remaining Balance |
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| Interest Rate on 2nd Lien |
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| Describe the Neighborhood |
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| The Property's Current Condition Is |
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| The Property Needs (Repair Status) |
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| Is Any Tenant or Note Payor Facing Eviction |
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| Is This Mortgage Recorded at the County Courthouse |
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| Date of Note Origination (M/D/Y) |
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| When Was the First Payment Received (M/D/Y) |
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| When Was the Last Payment Received (M/D/Y) |
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| When is the Next Payment Due (M/D/Y) |
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Why Did You Take Back This Mortgage?
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If The Buyer Didn't Qualify For A Bank Loan, Why Was The Loan Turned Down?
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Why Are You Exploring The Sale of This Note At This Time?
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| What Do You Feel Is A Fair Price For Your Note? |
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| For Office Use Only |
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