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
Required* 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 =

Mortgage Information Worksheet