Business Note Quotation Form

Note Holder's Name
Note Holder's Email Address
Contact Phone		Contact Fax

Business Note Information Worksheet

Property's Original Sales Price		Down Payment
Note's Monthly Payment		Note's Term
Note's Original Balance		Note's Interest Rate
Note's Interest Rate is	Fixed	Variable
Date of Note's First Payment		Is This Note Current?	Yes No
Number of Note Payments made		Payments remaining
Is there a Balloon Payment?	Yes	No Balloon
If a Balloon, what is the amount?		Balloon's Due Date
Note's Lien Position	First Position Lien	Second Position Lien
Business's Appraised Value		Appraisal Date
Is this Note secured with Real Estate?		Yes No
Is this Note secured with Equipment?		Yes No
Is the business location leased or owned?		Leased Owned
Additional business Information such as the type of business, time in operation, profitability, etc.
Credit of Payor if known	Excellent Good Fair Poor Unknown
Is the Note guaranteed?	Yes No
Is the Payor in the Armed Forces?	Yes No
If "Yes", is Payor deployed?	Yes No
Quote Type Request	Entire Note Balance Balloon Balance Give me some options
Additional quote request information such as the amount of funds required and reason for the note sale.

Please answer the math question. The sum of 9 + 3 =

Business Note Information Worksheet