Note Application - EMD Xpress

First Name

Last Name

Email Address

Phone Number

Property Type

How many years did you own the property before selling it?

Property Street Address

Property City

Property ZIP Code

Property State

Square footage of buildings (for Commercial or Business Notes or N/A)

How many years has the business been there? (for Commercial or Business Notes or N/A)

Ever have fuel tanks or other environmental factors?

Yes No

Property Description (amenities, condition of structures, etc.)

Current Estimated Property Value

Date of Sale

Sales Price

Did the sales price include business (non-real estate) assets?

Yes No

Cash Down Payment

Original Note Amount

Interest Rate

Term of Note (in years)

Payment Amount

Date of First Payment

Number of Payments Made So Far

Current Balance on Note

Number of Late Payments in last 12 months

Number of Remaining Payments

Is there a balloon payment?

Yes No

Who occupies the property?

Credit of Buyer/Borrower

Do you use a 3rd-party company to service the payments?

Yes No

Other information about the property, the note, or the payer:

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