Are you the note holder or are you assisting someone? *	I'm the owner. I'm assisting the owner.
Note Holder Information
First Name *
Last Name *
Phone Number *
E-mail *
How did you hear about us? *
Why are you selling the note? *
What is the desired amount for the note? *
Property Information
Street address *
City *
State *	AL AK AR AZ CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Estimated present value: *
Date the buyer purchased the property:
Purchase price of property:
Type of Property: *	Single Family Res. DuPlex Tri-Plex Four-Plex Commercial Vacant Land Other
Sq. Feet: *
Lot Size: *
Bed Rooms: *
Bathrooms: *
Property Across Description: *
Property Adjacent Description: *
Property Behind Description: *
Liens/Judgments? *	Yes No
Taxes current? *	Yes No
Currently: *	Owner Occupied Rental Vacant
Note Information
Type of Note: *	Full Am Interest only Balloon
Original amount of note: *
Terms in months: *
Interest rate: *
Due date of payments:
Payment amount: *
Unpaid balance of note: *
Payments current? *	Yes No
# of payments made to date: *
Balloon amount:
Balloon date:
Title Insurance? *	Yes No
Do you want to sell whole note or partial? *
Information Regarding the Property Owner
Employment of the property owner: *
Credit: *	Good Fair Poor
Credit Score:
Authorized to update credit report:	Yes No
Authorization to update credit assignable:	Yes No
Upload helpful documentation:
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