Quote Request Form - Residential Property 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 below)

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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