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Business/Commercial Note
Fill out this form to submit it online now.  If you prefer, you may call us to discuss the information by phone.  You may also email or fax the completed form.  You will receive confirmation when we receive your information
Contact Information
First Name:
Last Name:
Address:
City:
State:
Zip Code: (5 digits)
Phone:
Email:
Are you personally receiving payments on this note?:
If not, you are a:
Note Information
Face Value/Original amount of note for sale:
Sale Price:
Down Payment:
Interest Rate:
Note Balance:
Sale Date:
Payment Amount:
Payments are Made:
Original Term:
Type:
# Payments Made:
Date of First Payment:
# Payments Remaining:
Date Next Payment Due:
Current or Delinquent?:
LTV:
Position of Note:
Business Information
Type of Business:
Age of Business (years):
Payor's Credit Score:
City:
State:
Value:
Is land included?:
Property Size:
Property Usage:
How is the Property Zoned?:
Value of Hard Asset Collateral:
Net Operating Income:
Gross Income:
Other Liens
Balance:
Remaining Term:
Payment Amount:
Interest Rate:
Debt Coverage Ratio:
 
 
Other Information
Comments: