*All data is kept strictly confidential, and will not be sold or marketed*

                                                        Address of the property securing the Note?   Street, City, State, Zip
                                                       

                                                        Does the Note payor live there?  Yes / No  

                                                        (If not) Is the property rented?  Yes / No  

                                                        For How much?   $

                                                        TypeOfInstrument?   Mortgage, Deed of Trust, Contract, etc.
                                                       

                                                        Type of property?   Single Family, Condo, Duplex, Mobile (year? size?) 
                                                        Lot / Land,  Apt. Building / Units, Shopping Center, Office Building, etc.
                                                       

                                                        Sales date of property?   

                                                        Sales price of property?   $

                                                        Cash down payment?   $

                                                        Is the Note in 1st position?  Yes / No  

                                                        Original amount of the Note?
                                                      $

                                                        Interest rate?   %

                                                        Monthly payment?   $

                                                        Does payment include taxes & insurance?  Yes / No  

                                                        Months / Years Financed?  

                                                        Current balance?   $

                                                        Date of first payment?  

                                                        Next payment due?  

                                                        What is the payor(s) credit score?  

                                                        If you do not know their score, we can check credit for you by 
                                                        providing us with their name, address and social security numbers.
                                                       

                                                        Your name  

                                                        Phone        Best time to call  

                                                        Your address  

                                                        Email  

                                                        Additional Comments
                                                       

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