NOTE SELLER QUOTE REQUEST

Sell Your Note For Top Dollar!

For faster service, please fill out as much information as possible in order to avoid delays.

CONTACT'S FIRST NAME: *
CONTACT'S LAST NAME: *
EMAIL: *
Home Phone:
Work Phone:
Cell Phone:
CONTACT'S STREET ADDRESS:
CITY:
STATE:
ZIP CODE:
PROPERTY TYPE: *
PAYORS CREDIT SCORE (if known):
PROPERTY VALUE:
DATE OF LAST APPRAISAL:
IS PROPERTY OWNER OCCUPIED?: *	Yes No
DATE PROPERTY SOLD?:
SALE PRICE:
COMPLETE ADDRESS OF PROPERTY:
HOW MUCH WAS BUYER'S DOWN PAYMENT?:
FACE VALUE OF YOUR NOTE?: *
NOTE BALANCE::
INTEREST RATE ON NOTE:: *
PAYMENT AMOUNT: *
PAYMENTS MADE:
WHEN WAS THE FIRST PAYMENT MADE?:
# OF PAYMENTS REMAINING?:
NEXT PAYMENT DUE DATE::
IS YOUR NOTE::	CURRENT DELINQUENT
POSITION OF NOTE::
LTV (if known):
FIRST REMAINING BALANCE::
SECOND REMAINING BALANCE::
IS THERE A BALLOON PAYMENT?:	Yes No
IF YES, AMOUNT DUE::
HOW DID YOU HEAR ABOUT US?:
REASON FOR CASHING OUT NOTE (optional)::
NAME OF PERSON COMPLETING THIS FORM (IF NOT THE NOTE HOLDER):
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