Mortgage Note Submission Worksheet
Broker / Principal Information
Name..................................................................................................... Date...............................
Company........................................................................................................................................
Address ..........................................................................................................................................
City....................................................................... State…………………. ZIP................................
Phone .................................................................. Fax...................................................................
Real Estate Information
Street address……………………………………. County ……………………………………………
City ………………….. State................................ ZIP...................................................................
Current estimated value $................................... Based on...........................................................
Residential o Single-family o Multi-family
o Owner-occupied o Rental Commercial Description______________________________________
Commercial Description………………………………………………………
o Owner-occupied o Rental
Vacant land Description………………………………………………………
Description of Real Estate Property & Area………………………………………………………
...................................................................................................................................................................................
Historical Information Prior Mortgage Information (if any)
Date of sale ....................................... .................................................................
Selling price $....................................... .................................................................
Down payment $....................................... .................................................................
First lien $....................................... .................................................................
Second lien $....................................... .................................................................
Note Information Payor Information
Date of note ....................................... (Employment info, payment history, SSN)
Amount $....................................... ........................................................
Term in months …………. (a)………….(b) ............................................................................................
Payment amount $....................................... .................................................................
Balloon amount $....................................... .................................................................
Balloon date $.......................................
Interest rate ....................................... % Seller’s Motivation/Need
Due date 1st pmt ....................................... .................................................................
# of pmts paid ....................................... .................................................................
# of pmts left ....................................... .................................................................
Next pmt due ....................................... .................................................................
Balance $.......................................
I have copies of the following:
Quote to Seller Note o Yes o No
Security instrument o Yes o No
Buy Total Note $....................................... Title o Yes o No Buy _____ pmts for $....................................... Sales contract o Yes o No
Buy _____ pmts for $....................................... Payor credit report o Yes o No Date of quote ......................................... Closing statement o Yes o No
Closing costs paid by ……………………………. Bill of sale o Yes o No
Insurance o Yes o No Appraisal Yes No
Prior mortgage info o Yes o No
Broker / Principal Information
Name..................................................................................................... Date...............................
Company........................................................................................................................................
Address ..........................................................................................................................................
City....................................................................... State…………………. ZIP................................
Phone .................................................................. Fax...................................................................
Real Estate Information
Street address……………………………………. County ……………………………………………
City ………………….. State................................ ZIP...................................................................
Current estimated value $................................... Based on...........................................................
Residential o Single-family o Multi-family
o Owner-occupied o Rental Commercial Description______________________________________
Commercial Description………………………………………………………
o Owner-occupied o Rental
Vacant land Description………………………………………………………
Description of Real Estate Property & Area………………………………………………………
...................................................................................................................................................................................
Historical Information Prior Mortgage Information (if any)
Date of sale ....................................... .................................................................
Selling price $....................................... .................................................................
Down payment $....................................... .................................................................
First lien $....................................... .................................................................
Second lien $....................................... .................................................................
Note Information Payor Information
Date of note ....................................... (Employment info, payment history, SSN)
Amount $....................................... ........................................................
Term in months …………. (a)………….(b) ............................................................................................
Payment amount $....................................... .................................................................
Balloon amount $....................................... .................................................................
Balloon date $.......................................
Interest rate ....................................... % Seller’s Motivation/Need
Due date 1st pmt ....................................... .................................................................
# of pmts paid ....................................... .................................................................
# of pmts left ....................................... .................................................................
Next pmt due ....................................... .................................................................
Balance $.......................................
I have copies of the following:
Quote to Seller Note o Yes o No
Security instrument o Yes o No
Buy Total Note $....................................... Title o Yes o No Buy _____ pmts for $....................................... Sales contract o Yes o No
Buy _____ pmts for $....................................... Payor credit report o Yes o No Date of quote ......................................... Closing statement o Yes o No
Closing costs paid by ……………………………. Bill of sale o Yes o No
Insurance o Yes o No Appraisal Yes No
Prior mortgage info o Yes o No