Quote Request Form - Mortgage Note

Your Name :    

Address :        

City :                               State/Prov :           

Country :                          Zip/Post. code  :       

Phone no:                               Email :              

Property Information

Prop. Type:       Single Family ResidenceDuplex / FourplexCondo / TownhomeCommercialLand onlyLand with improvements (utilities)Other (Please explain in Comments)

Address :         

City :                                State/Prov :           

Country :                           Zip/Post. code  :        

Selling Price :                    Down Payment  :       

1st Mortgage:                   2nd Mortgage :         

Owner Occupied:    YesNo    Title Policy :  YesNo       Appraised Val   :   

Note Information

Type :                 Mortgage NoteDeed of TrustLand ContractContract for Deed                       Orig. Balance :          

Mortgage date:                  Term (Months/Years) : 

Mnthly pymt :                     Interest Rate:                 

Balloon amt:                       Balloon date :                  

Date 1st pymt :                  # pymts made :                

# Rem. pymts :                   Next pymt. due :              

Curr. balance :      Type of purch. you are interested :  Full PurchasePartial Purchase

Special Clauses                 Reasons for selling :

 Payor Information

Payor name :                Address : 

Payor Credit :  Please SelectA - ExcellentB - GoodC - Below AverageD - Poor

Documents Available

Could you provide copies of the following documents upon request ?

Note, Deed of Trust /Contract   NoYes   Escrow Closing Statement  NoYes   Title Insurance   NoYes

Current Hazard Insurance           NoYes               Payment Records     NoYes  Curr. pic/apprsl   NoYes

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