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Are you personally receiving payments on this note?	Yes No
Type of Property
Payor's Credit
Property Value
Owner Occupied?
Sales Date (Month/Date/Year)
Sales Price
Down Payment
Property Address
State
City
Original Note Amount
Note Balance
Interest Rate
Payment Amount
Payments Made
# of Payments Made
When 1st Payment Made (Month/Date/Year)
# of Payments Remaining
Next Payment Due Date (Month/Date/Year)
Current	Current Delinquent
Balloon Payment
How Much Balloon Payment
When Balloon Payment Due (Month/Day/Year)
Position of Note
1st - Remaining Balance
2nd - Remaining Balance
Comments

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Note Balance
Comments

Win Amount
Win Date (Month/Day/Year)
State
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Are you personally receiving payments on this note?	Yes No
Note Balance
Comments

Face Value of Note For Sale
Interest Rate
Payment Amount
Payments Made
When 1st Payment Made (Month/Day/Year)
# of Payments Made
# of Payments Remaining
Next Payment Due Date (Month/Day/Year)
Current	Current Delinquent
Balloon Payment
How Much Balloon Payment
When Balloon Payment Due (Month/Day/Year)
Position of Note
1st - Remaining Balance
2nd - Remaining Balance
Type of Property
Payor's Credit
Property Value
Owner Occupied?
Year of Mobile Home
Size of Mobile Home
How Much Land is Part of Collateral
Sales Date (Month/Date/Year)
Sales Price
Down Payment
Loan to Value
Property Address
State
City
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Contact State
Are you personally receiving payments on this note?	Yes No
Note Balance
Comments

Insurance Company Making Payments
Payment Amount
Payments Made
# of Payments Remaining
Type of Accident
Age of Recipient
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Original Judgment Amount
Current Balance
Defendant
Have Any Payments Been Made?	Yes No
How Much?
Judgment State
Comments

Payments Made
Are Payments Current?	Yes No
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Contact First Name
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Are you personally receiving payments on this note?	Yes No
Note Balance
Interest Rate
Date of Purchase (Month/Day/Year)
Down Payment
Payment Amount
Payments Made
# of Payments Made
# of Payments Remaining
Current	Current Delinquent
Did you have this Note Registered	Yes No
Did you do a UCC-1 filing for this note?	Yes No
Position of Note
Type of Business
Payor's Credit
Property Value
Propertry Size
Property Usage
Property Address
State
City
Comments / Description of Business

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Contact First Name
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Are you personally receiving payments on this note?	Yes No
Payment Amount
Payments Made
Please Explain Additional Payments

# of Payments Remaining
Assignable	Yes No
Resulted From
Other, Please Explain
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