Mortgage Quote Request

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MORTGAGE NOTE QUOTE REQUEST FORM

Please fill out the following form in its entirety and as accurately as possible to ensure the highest quote. If you prefer you can simply download the form in PDF format and fax it back to us at 888-755-8521.
NOTE: It is First Capital Funding Corporation's policy that the broker must be working directly with the note seller to obtain bid. No quotes from notes posted on web sites or from multi-brokers.

IF THIS IS A SIMULTANEOUS CLOSING PROPOSAL (THE NOTE HAS NOT YET BEEN CREATED) PLEASE CLICK THIS LINK TO COMPLETE THE SIMULTANEOUS CLOSING FORM INSTEAD.

Full Purchase: Complete and total purchase of all remaining payments including a balloon.	Multiple Stage Payout: The purchase of your instrument with designated lump sum payments (i.e. annually, quarterly, etc.).
Reverse Partial: The purchase of future payments allowing the seller to continue receiving payments for a specified period of time.	Partial Purchase: The purchase of any designated number of immediate payments. The seller may receive additional installments on the note.
Split Disbursement Partial: The purchase of a portion of each payment - allowing the seller to receive the other portion of the payment.	Simultaneous Closing: The purchase of a seller financed note which occurs simultaneously with the sale of real property. This type of purchase may be combined with others to allow flexibility for the seller

Contact Information
The person completing this form Is:
Name:		Email:
Address:		City:
State:		Zip:
Daytime Phone:		Evening Phone:
Cell:		Fax:
Are you personally receiving payments on this note?:
When is the best time to contact you?
Property Information
Property Address:		City:
State:		Zip:
County:
Property Type:
Property is:
Size of property (Acreage)
Age of Structure:
Please give us a brief description of the property and/or other improvements. If land be sure to include if it has water, electricity, paved roads, dimensions, etc:
Note Information
Date of Sale:
Sales Price:
Down Payment:
Original Note Amount:
Current Balance:
Date of First Payment:
Next Payment Due:
Principal and Interest Payment:
Interest Rate:
Lien Position
If Wrap or AITD indicate amount of senior lien:
Balloon Date (if applicable):
Payments on Time or Delinquent?
Current Estimated Value of Property:
Based on?
Credit score of the prospective buyer?
Other Information: Please provide any other additional information that would assist us in preparing an accurate quote, such as whether the interest rate is adjustable, whether future payment amounts may change, an additional principal payment, estimated credit of the payor or credit if known, the acreage on lots that exceed five acres, the type of businesses located on commercial property, etc.:
Marketing Purposes
Please tell us how you find us
If by search list keywords used:
If other please explain: