Fax Quote Form

Name: ________________________________

Phone: ________________________________

Email: ________________________________

Property Address City: ________________________________ State: _______

Type of Property:________________________________ Owner Occupied? (yes/no) _______

Sale Price: $ ____________________ Date of Sale: ________________________________

Property Value: $ ____________________

How Was This Value Established (appraisal, etc) ? ________________________________

1st Loan Amount: $ ____________________ Monthly Payment: $ ____________________

2nd Loan Amount: $ ____________________ Monthly Payment: $ ____________________

Down Payment Amount: $ ____________________

As of: ________________________

Original Amount: $ ____________________ Balance: $ ____________________

Interest Rate: _______% Payment Amount $ ____________________

Original Length: _______ months Date of 1st Payment: ____________________

Number of Payments Made: _______ Number Remaining: _______

Are Payments on Time? _______ What Day of Month Are They Due? ____________________

Balloon Pmt. (if any): $ ____________________ Balloon Pmt. Date: ____________________

What Does Payor Do For Living? ________________________________

Payor's Credit Score: ________________________________

Any Comments About Property? _______________________________________________________

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