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Broker Worksheet


NOTICE: For your protection, this worksheet is secured by a 256-bit, SSL secure connection to our server.

Broker Information

Name
Phone
Fax
Broker Address
E-Mail Address

Property Location


Payor Information (The Payor is the borrower - the party currently making payments on the loan you wish to obtain pricing.)

Payor Name
Payor SSN


Property and Lien Type (multiple selections allowed)

First Lien Owner Occupied Non-owner Occupied
Second Lien Single Family Multi-Family
Contract-for Deed Duplex Commercial Income
Wrap Lien Triplex/Fourplex Land (only)
Direct (Non-purchase money) Mobile Home (with land) Farm or Ranch
Other:
Rural
City
Current Appraised / Estimated Value $:


Sales Information

Sales Price $

Date

Cash Down Payment $

First Mortgage $

Second Mortgage $


Terms of Note For Sale

Date of Origination

Face Amount $

Term (months)

Payment $

Balloon Term

Current Balance $

Interest Rate

Balloon Amount $(if any)

First Payment Due Date

Next Payment Due Date

# Payments Made

# Payments Remaining

Are Payments Current
Within Last 12 Months?
YES- NO-
Any Known
Credit Problems?
YES- NO-
If so, please explain


Terms of Underlying Note (if exists)

Date of Origination
Face Amount $
Term (months)
Balloon Term
Current Balance $
Interest Rate
Payment Amount $
Balloon Amount $
First Payment Due Date
Next Payment Due Date
# Payments Made
# Payments Remaining
Name




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1-800-535-3337918-663-3337