SUBMIT YOUR NOTE Your InformationAre you a seller or a broker?* Seller BrokerYour Name* First Last Email Address* Phone Number*Property Location* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Payor InformationThe Payor is the borrower - the party currently making payments on the loan you wish to obtain pricing.Payor Name* First Last Payor SSNIf ApplicableProperty & Lien InformationProperty Type* Single Family Duplex Triplex/Fourplex Mobile Home (with land) Multi-Family Commercial Land (only) Farm or Ranch Rural OtherSpecify Other Property Type*Lien Type* First Lien Second Lien Wrap Lien Direct (Non-purchase money)Occupancy* Owner Occupied Non-owner OccupiedSecurity Instrument* Note Mortgage Deed of Trust Security Deed Contract For Deed Land Contract Lease Purchase Option OtherSpecify Other Security Instrument*Current Appraised/Estimated Value ($)*Sales InformationSales Price ($)*Sales Date* MM slash DD slash YYYY Cash Down Payment ($)*First Mortgage ($)Second Mortgage ($)Terms of Note For SaleDate of Origination* MM slash DD slash YYYY Loan Amount ($)*Amortization Term (months)*Principle & Interest Payment Amount*This amount should not include taxes and insurance.Do you collect for taxes and insurance?* Yes NoAmount Per Month ($)*Are there any HOA dues?* Yes NoHow Much Per Month ($)*Balloon TermCurrent Balance ($)*Interest Rate*Balloon Amount (if any)First Payment Due Date* MM slash DD slash YYYY Next Payment Due Date* MM slash DD slash YYYY Last Payment Made* MM slash DD slash YYYY # Payments Made*# Payments Remaining*Have any of the payments been over 30 days late within the last 12 months?* Yes NoIf yes, how many?*Any known credit problems?* Yes NoIf so, please explain*Did you evaluate the Payor's credit at the time of sale?* Yes NoIf yes, what was their score?*Any additional comments?Is there an underlying note?* Yes NoTerms of Underlying NoteDate Of Origination* MM slash DD slash YYYY Face Amount ($)*Terms (months)*Balloon TermCurrent Balance ($)*Interest Rate*Payment Amount ($)*Balloon Amount ($)First Payment Due Date* MM slash DD slash YYYY Next Payment Due Date* MM slash DD slash YYYY Last Payment Made* MM slash DD slash YYYY # Payments Made*# Payments Remaining*CommentsThis field is for validation purposes and should be left unchanged.
