REAL ESTATE NOTE FUNDING APPLICATION Today's Date MM slash DD slash YYYY Name First Last Email* PhoneYour Mailing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How Did You Hear About Us?Please Select an OptionPostcardLetterNewspaper AdEletterOnline AdReal Estate AgentAttorneyCPA or AccountantGoogle SearchYahoo SearchBing SearchOtherPROPERTY INFORMATIONPlease tell us about the property you are receiving payments on.Property Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Type of Property*Please Select an OptionSingle Family HomeCondoTownhouse2-4 Rental Units5+ Rental UnitsDouble Wide Mobile Home With LandSingle Wide Mobile Home With LandImproved Residential LotImproved LandRaw LandCommercial PropertyBusiness Only – No Real EstateMobile Home Only – No LandOtherYear Property Built AcreagePlease Select an OptionLess Than 1 Acre1 to 5 Acres6 to 10 Acres11 to 20 AcresMore Than 20 AcresProperty DescriptionOccupancy Owner Occupied Rental Vacant Current Estimated Value of Property NOTE INFORMATIONPlease provide information on the Mortgage Note, Trust Deed, or Real Estate Contract.Sale Date/Date of Note Month Day Year Property Sale PriceDown Payment AmountOriginal Starting Balance of NoteCurrent Principal Balance of NoteInterest Rate Payment AmountPayment ScheduleMonthlyWeeklyQuarterlySemi-AnnuallyAnnuallyIs There an "All Due" or "Balloon Payment" Date? Yes No Balloon Payment Date Are Payments Current? Yes – Current No – Delinquent If Payments Are Delinquent, Please Describe Payment HistoryWho Collects Payments? Seller Collects Directly From Buyer/Payer Third Party Servicer If Third Party Collects Payments Please Provide the Company Name, Address, and Account NumberIs This a First Position Note? Yes No If No, Please Provide Amount of First Mortgage ADDITIONAL INFORMATIONBuyer or Payer's Credit Score Please Let Us Know of Any Special Circumstances or Reasons for Selling the NotePlease Send the Following Documents:• A copy of the Promissory Note • A copy of the Deed of Trust, Mortgage, or Land Contract • A copy of the Closing Statement • A copy of the original title insurance policy • Buyer information — name, address, and social security number • Pay history and current balance • Copies of underlying notes and balances (if applicable) • A copy of the current Proof of Insurance (hazard insurance) NOTE: It is helpful to have copies of the transaction documents to provide a more accurate note analysis. You can fax them to 888-841-3728, mail them to our office address, or upload attached copies of documents from your computer with the following link:Copies of DocumentsMax. file size: 512 MB.Are You Providing Copies of Documents at This Time? Yes – By fax Yes – By mail Yes – Copies included in attached upload No – Documents will follow at a later date Additional CommentsAre You Ready to Send This Online Form?* Yes No When you are ready to send the information please select “Yes” and then click on the Submit Button below.