| |
| Contact Information |
| First Name: | |
| Last Name: | |
| Address Street 1: | |
| Address Street 2: | |
| City: | |
| State: | |
| Zip Code: | (5 digits) |
| Phone: | |
| Email: | |
| Are you personally receiving payments on this note?: | |
| If not, you are a: | |
| |
| Property Information |
| Property Address: | |
| Type of Property: | |
| Property Value: | |
| Owner Occupied?: | |
| Sale Date: | |
| Sale Price: | |
| Down Payment: | |
| Note Information |
| Face Value (original amount) of note for sale: | |
| Payor's Credit Score: | |
| Note Balance: | |
| Interest Rate: | |
| Payment Amount: | |
| How Often are Payments Made?: | |
| Original Term: | |
| Type: | |
| # of Payments Made: | |
| Date First Payment Made: | |
| # of Payments Remaining: | |
| Next Payment Due Date: | |
| Are Payments Current or Delinquent?: | |
| Loan to Value (LTV): | |
| |
| Balloon Information |
| Balloon Payment? | |
| Balloon Payment Amount: | |
| Balloon Payment Due Date: | |
| |
| Lien Information |
| Position of Note: | |
| First - Remaining Balance: | |
| Second - Remaining Balance: | |
| |
| |
| Other Information |
| |
| |
