Form

Cover Letter
Tell us everything you know about the note/deal:*
Broker Information
This section only needs to be filled out if a broker/3rd party is submitting the information.
Broker Name:
First Name Last Name
Company:
Title:

Broker Address:

Broker Phone Number:
- Area Code Phone Number
Broker E-mail:
Broker Fax:
- Area Code Phone Number
Are you direct contact with the note holder?:
If no, how many brokers are between you and the direct owner?
We require that you be in direct communication with the note holder. We do not entertain broker/daisy chains.
Contact Information of Client
Client Name:*
First Name Last Name

Client Address:*

Client Phone Number:*
- Area Code Phone Number
Client E-mail:*
Client Fax:*
- Area Code Phone Number
How much do you need to liquidate this note?:*
Note Information
Face Value/Original amount of note for sale:*
Sale Price:*
Down Payment:*
Interest Rate:*
Note Balance:*
Sale Date:*
Payment Amount:*
Payments are Made:*
If other, please explain:
Original Term:*
Type:*
If other, please exlain:
# of Payments Made:*
Date of First Payment:*
#of Payments Remaining:*
Date Next Payment Due:*
Current or Delinquent?:*
LTV:*
Position of Note:*
Business Information
Type of Business:*
Age of Business (years and months):*
Payor's Credit Score:*
City:*
State:*
Value:*
Is land included?:*
Property Size:*
Property Usage:*
How is the Property Zoned?:*
Value of Hard Asset Collateral:*
Net Operating Income:*
Gross Income:*
Other Liens
This section only needs to be completed if there are any other liens on the property.
Balance:
Remaining Term:
Payment Amount:
Interest Rate:
Debt Coverage Ratio:
Comments:
Enter the code as it is shown:*
Should be Empty:

Cover Letter