Your name Your email address Your home phone number Your day time phone number Best time to call Are you personally receiving the payments YesNo Note balance How secured Business onlyReal estate and businessReal estate only Please describe the business How was the note originated Please describe the premises Interest rate When originated M D Y Down payment Payment amount When payments made MonthlyQuarterlyAnnually Number of payments made Number of payments left Current CurrentOne month behindMore than one month behind Value of real estate if included Position of note FirstSecond Describe any other financing Please descibe any balloon payments Borrowers credit if known A 700 or aboveB 630 to 699C 630 to 669D Below 630Not known Business City Business state
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