For a no obligation cash quote fill out the worksheet below.

                          NOTE SUBMISSION WORKSHEET

Submitted By _______________________   Phone Number (_____)______

Date ___ /___ /___  

Street _________________________________  

City_______________________  State ___________   Zip Code______

MORTGAGE     TRUST DEED     WRAP    LAND CONTRACT    R.E. CONTRACT 

OTHER ____________________      (choose one)

PROPERTY INFORMATION

Property Type ________________________________

Owner Occupied    Rental    Commercial    (choose one)

Street _____________________________________        

City _______________________   State _____________ Zip Code ________ 

Room Count:  BDR ____ BTH ____Other _______  

Square Footage ________________ Lot Size _____________

Date Of Sale _______ Sales Price $ _________  Down Payment $________

First $ _____________ Second $________________ Other $ ____ 

Current Balance Owing $__________  

NOTE INFORMATION

Amount $__________   Date of Note_______   Term__________  

Balloon Due Date__________  

Interest Rate_______   Payment Amount $_______  

Monthly  Quarterly  Semi-Annual  Annual  Other_______choose one

Due Date of First Payment__________  Pmts Made____  

Pmts Remaining__________  Next Pmt Due__________ 

NOTE SELLER INFORMATION

Name_________________________  Name_________________________

Street__________________________________

City___________________   State_____________  Zip Code_______

NOTE PAYER INFORMATION

Name_________________________ Name_________________________ 

Street__________________________________

City_________________________State_____________  Zip Code____

Home Phone Number (___)_______  Work Phone Number (___)______

SS# ___-__-_____      SS# ___-__-_____     

Employer____________________________________________________

PRIOR LIENS 

Institution___________________    Phone Number (___ )_______

Account Number ________________ 

Street__________________________________ 

City ___________________ State ________________ Zip Code ____

Position _______ Current Balance Owing $___________________  

Payment Amount $_____________  Term Remaining_______  


Comments__________________________________________________
____________________________________________________________

Submit with copies of the Mortgage/Trust Deed, Note, Closing
 Statement, and an original picture of the property.