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First Name
Last Name
Address Line 1
City
State
Zip Code
Daytime Phone
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Evening Phone
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Fax
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E-mail Address
Comments
Property Street Address
Property City
Property State
Property Zip
Property County
Property Owner Occupied?
Property Description
Payor Name/s
Payor City
Payor Street Address
Payor State
Payor Zip
Payor Social Security #
Security Instrument
Lien Position
Date of Sales
Sales Price
Down Payment
Beginning Balance
Current Balance
Interest Rate
P/I Payment Amount
First Payment was Due
Payment Frequency
Next Payment is Due
Balloon (if any) Due
Balloon Amount
# of Payments Made
# of Payments Remaining
Well There Be Any Payoffs at Closing?
If So, What are the Amounts?
If this receivable will be purchased as a junior position, what is the outstanding balance/s of the senior position?
List Amounts of Any junior liens behind the subject receivable
Note Holder First Name
Note Holder Last Name
Note Holder Address
Note Holder City
Note Holder State
Note Holder Zip Code
Note Holder Daytime Phone
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Note Holder Evening Phone
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Note Holder Fax
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Note Holder E-mail Address