Please fill out the following form in its entirety and as accurately as possible to ensure the highest quote. It is First Capital Funding Corporation's policy that the broker must be working directly with the note seller to obtain bid. No quotes from notes posted on web sites or from multi-brokers.
If you prefer you can simply download the form in PDF format and fax it back to us at 888-755-8521.
DO NOT SUBMIT A SIMULTANEOUS CLOSING PROPOSAL (THE NOTE HAS NOT YET BEEN CREATED)
The person completing this form is:
First Name:
Last Name:
Address Street:
Address Street 2 as needed:
City:
Zip Code:
State:
Your Contact Information
Daytime Phone:
Evening Phone:
Cell Number:
Fax Number:
Email:
Are you personally receiving payments on this note?
Property Sales Date:
Sales Price
Down Payment Made
Original amount of the Note:
Current Balance
Term in Months
When was the first payment made on this note?
Next payment due date:
Number of payments made:
Number of payments remaining?
Principal and Interest Payment Amount:
Interest Rate:
Lien Position:
If Wrap or AITD indicate amount of senior lien:
Instrument Type
Is there a Balloon?
If yes, what is the Balloon payment amount:
Balloon payment date:
Are the note payments delinquent or current:
Property Estimated Value:
Based on:
Payor's credit rating if known?
If there is a 2nd Note what is the Remaining Balance?
Location State:
Location City:
Location County
Property Type:
Owner Occupied?:
Please Tell us how you found us:
If via a search engine, can you tell us what keywords you used?
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