Mortgage Note Application — Real estate mortgage note buyer!

First Name *

Last Name *

Email Address *

Phone Number *

Property Type *

How many years did you own the property before selling it? *

Property Street Address *

Property City *

Property ZIP Code

Property State

Property Description (size, amenities, condition of structures, etc.) *

Current Estimated Property Value *

Date of Sale

Original Note Amount *

Cash Down Payment

Sales Price

Interest Rate

Term of Note (in years)

Payment Amount

Date of First Payment

Number of Payments Made So Far

Current Balance on Note

Number of Late Payments

Is there a balloon payment?

Yes

No

Number of Remaining Payments

Who occupies the property?

Credit of Buyer/Borrower

Are there any loans or liens against the property?

Yes

No

Other information about the property, the note, or the payer:

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