21st Century Funding Worksheet for Real Estate

Your Email Address:

Contact Information

Your Name	
Date		
Phone		
FAX

Historical Information

Date of Sale	
Selling Price	
Down Payment	
1st Lien	
2nd Lien

Note Information

Date of Note		
Account	($)		
Term in months		
Payment account		
Balloon Amount		
Balloon Date		
Interest Rate		
Due Date 1st PMT	
# of payments paid	
# of payments left	
Next Payment due	
Balance

Description of Property, Location & Area

Payor Information

Please provide as much information as you can about the person making payments to you (Employment Info, Payment Record, Payor S.S.#, etc.)

Motivation Information

Please explain why you need to sell the debt instrument, how much you expect for it, and how soon you need to close.

Pertinent Documents

Do I have the following:
Yes No - Note
Yes No - Security Instrument
Yes No - Title
Yes No - Sales Contract
Yes No - Payor credit report
Yes No - Closing Statement
Yes No - Bill of sale
Yes No - Insurance
Yes No - Lease
Yes No - Franchise agreement
Yes No - UCC-1

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