| Your Name |
|
| Your email address |
|
|
| Day phone number |
|
| Evening phone number |
|
| Best time to call |
|
| Are you personally receiving payments on this note |
|
| Principal balance owing |
|
| Type of real estate |
|
| Payer credit score, if known |
|
| Current property value |
|
| How property value determined |
|
| Sale date M D Y |
|
| Sale price |
|
| Down payment |
|
| Real estate city |
|
| Real estate state |
|
| Original balance of note |
|
| Interest rate % |
|
| Payment amount |
|
| When are payments made |
|
| Original Total Number of payments of note |
|
| When first payment was made M D Y |
|
| Number of payments remaining (if known) |
|
| When next payment is due M D Y |
|
| Priority of note |
|
| Amount of first, if note is 2nd or 3rd |
|
| Balloon on first, if note
is 2nd or 3rd |
Yes |
| No |
| When does first balloon, if note is 2nd or 3rd |
|
| Amount of 2nd mortgage, if note is 3rd |
|
| Balloon on second, if note
is 3rd |
Yes |
| No |
| When does second balloon, if note is 3rd |
|
| Balloon payment this note |
Yes |
| No |
| Amount of balloon this note, if any |
|
| When is balloon due this note, if applicable M D Y |
|
| Is there a lenders title insurance
policy |
Yes |
| No |
| Payment history |
|
| Comments |
|
| |
