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Contract Buyer:  Receive a Conditional Quotation

Mortgage Note Quotation Form

Note Holder's Name(List all Names)
Note Holder's Email Address
Contact Phone Contact Fax
Note Payer's Name

Mortgage Information Worksheet

Property's Original Sales Price Down Payment
Note's Monthly Payment Note's Term
Note's Original Balance Note's Interest Rate
Note's Current Balance    
Note's Interest Rate is Fixed Variable  
Date of Note's First Payment Is This Note Current? Yes      No
Number of Note Payments Made Payments Remaining
Is There a Balloon Payment? Yes No Balloon  
If a Balloon, what is the Amount? Balloon's Due Date
Note's Lien Position First Position Lien Second Position Lien  
Property's Appraised Value Appraisal Date
Is there a Title Policy? Yes       No    
Property is Currently... Owner Occupied       Renter Occupied       Vacant   
Property Description  Single Family     Duplex     Triplex / Fourplex     Mobile Home
  Commercial         Vacant Land        Special Purpose / Other

Address of Property including City, State, and Zip

Please Indicate which one of the following Security Instruments was Used to Secure this Owner Financed Loan:

         (Mortgage & Note, Land Contract & Note, Trust Deed & Note or Contract for Deed
Credit of Payor if known Excellent     Good    Fair     Poor      Unknown
Is the Payor in the Armed Forces? Yes        No    
If "Yes", is Payor deployed? Yes        No    
Quote type request Entire Note Balance    Balloon Balance      Give Me Some Options
Additional quote request information such as amount of funds required and why you are selling the note.
Please answer the math question.   The sum of 9 + 3 =