Name:* |
|
Address:* |
|
City,
State, Zip:* |
,
,
|
Home
Phone: |
|
Work
Phone:* |
ext:
|
E-mail
Address:* |
|
Please
contact me by:* |
email,
home phone,
work phone |
Best
time to reach me: |
|
Property/Structure/Information |
Approx. Property
Value/Purchase Price:* |
$
|
Any
defaults?* |
If
so, why?
|
Property
Type:* |
|
Property
Address:* |
|
Property
City & State:* |
,
|
Existing
First Trust Deed |
Present
Balance:* |
$
(if none type "0") |
Original
Balance: |
$
|
Monthly
Payment: |
$
,
current or past due:
|
Interest
Rate: |
, Term:
|
Existing
Second Trust Deed |
Present
Balance: |
$
|
Original
Balance: |
$
|
Monthly
Payment: |
$
,
current or past due:
|
Interest
Rate: |
, Term:
|
Note
Information/Sale Request |
Original
Balance of Note:* |
$
|
Current
Balance of Note:* |
$
|
Note
Interest Rate:* |
|
Monthly
Payment:* |
$
|
Number
of Months to Maturity:* |
|
Note
Type:* |
|
Is
This a Seller Carryback Note?* |
|
Balance
of Underlying Loans: |
$
|
How
much would you like for this note?* |
$
|
Comments/other
issues: |
|
|