If you would like to submit a NOTE for us to consider buying, please enter information on the following form:

REAL ESTATE & PAYOR INFORMATION
Property Street Address:
City, State Zip	City: State: Zip:
County:
Property Description:	Single Family Mult-Family Mobile Home/Land Commercial Land Only Improved Land
Occupancy Status:	Owner Occupied Rental Vacant
Improvements:
*PROPERTY VALUE	$
Payer's Name:	First Name: Last Name:
Payer's Employment:
Credit Rating / Score
Payment History

NOTE INFORMATION
*Sale Price	$
*Down Payment	$	All Cash Sweat Equity Trade
*Amount Financed	$
*Interest Rate (Annual)	%
*Payment Amount	$ Do NOT include taxes and insurance!
*Original Term	(# of months of payments)
*Date 1st Payment Made
Date Last Payment
# of Payments Made
# Payments Remaining
Balloon Amount	$
Date Balloon Due
*BALANCE ON NOTE	$

*Reason for Selling Note:
*Asking Price for Note:	$
Amount of Cash Needed:	$