First Name

Last Name

Phone *

Email *

Property Address *

County

Estimated Property Value *

Current UPB (Unpaid Principal Balance) *

$

Original Note Amount *

$

Interest Rate *

Monthly Payment Amount *

$

Original Loan Term

• 15 years
• 20 years
• 25 years
• 30 years
• 50 years
• Don’t Know
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Term Remaining In Months *

Note Performance Status *

• Performing
• 30 Days Late
• 60 Days Late
• 90+ Days Late
• In Default
• Foreclosure Started
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Total Months Behind *

Total Amount in Arrears

Date of Last Payment *

Primary Reason For Default

• Job Loss/Unemployment
• Medical Issues/Disability
• Divorce/Separation
• Business Failure
• Death of Borrower
• COVID-19 Impact
• Interest Rate Adjustment
• Property Damage
• Refinance Fell Through
• Other Financial Hardship
• Unknown
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• List is empty.

Borrower Current Employment Status

• Employed Full-Time
• Employed Part-Time
• Self-Employed
• Unemployed
• Retired
• Disabled
• Student
• Unknown
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Borrower Estimated Annual Income

Borrower Credit Score

Borrower Still in Property? *

Occupied by borrower

No - Vacant

No - Tenant occupied

Unknown

Foreclosure Status

• Not Started
• Notice of Default Filed
• Notice of Sale Published
• Sale Date Scheduled
• Postponed/Stayed
• Completed - REO
• Completed - Third Party Purchase
• Bankruptcy Filed (Chapter 7)
• Bankruptcy Filed (Chapter 13)
• Loan Modification in Process
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• List is empty.

Foreclosure Sale Date

Estimated Foreclosure Costs Remaining

Property Condition *

Excellent

Good

Fair (needs minor work)

Poor (needs major work)

Don’t Know

Estimated Repair Costs

Property Occupied Status *

• Owner Occupied
• Tenant Occupied (Paying)
• Tenant Occupied (Non-paying)
• Vacant - Secured
• Vacant - Unsecured
• Unknown
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Monthly Rental Value

$

Property Tax Status

• Current
• Delinquent (amount in next field)
• Unknown
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• List is empty.

Delinquent Tax Amount

$

Note Purchase Interest *

Yes - Definitely want to purchase

Maybe - Need analysis and advice

No - Just analyzing for information

Asking Price for Note

$

Your Maximum Investment Budget

$

Desired Minimum ROI (%)

Investment Strategy Preference

• Modification/Workout
• Foreclosure and Flip
• Foreclosure and Hold/Rent
• Note Resale/Assignment
• Deed in Lieu
• Short Sale Facilitation
• Undecided - Need Recommendation
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• List is empty.

Investment Timeline

Quick flip (0-6 months)

Short-term hold (6-18 months)

Medium-term hold (1-3 years)

Long-term hold (3+ years)

Flexible

Available Documents

Original Promissory Note

Deed of Trust/Mortgage

Assignment Chain

Payment History

Property Appraisal

Title Report/Insurance

Borrower Financial Statements

Correspondence with Borrower

Legal/Foreclosure Documents

Property Inspection Report

None of the above

Note Documents Upload

Your Note Investing Experience *

• First-time note buyer
• 1-5 notes purchased
• 6-20 notes purchased
• 20+ notes purchased
• Professional note investor
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Urgency Level

• Immediate (need analysis within 24 hours)
• Soon (within 3-5 days)
• Standard (within 1 week)
• No rush (whenever convenient)
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