Business Note Quotation Request Worksheet

To receive a FREE, VALID Cash Purchase Quotation for your Business Note or Contract, complete the Worksheet below.

Click the SUBMIT button at the bottom of the form after you are satisfied with your answers.

That's all you have to do!

Following our review of your Note Information, your own personal Client Manager will contact you with a Note Cash Purchase Quotation to buy your note.

Please also email or fax us a copy of your signed Note and the note securing property/assets Purchase/Sale Agreement. Email to private@notefundingcenter.com Fax to 888-642-3997.

* Questions marked with an asterisk require answers.

* Required fields
Name *
E-mail Address *
Today's Date: *
Note Sale Desire: *
Your Mailing Street Address: *
Your Mailing City, State and Zip: *
Voice Phone: *
Fax:
Note Relationship: *
Note Business Property Street Address: *
Note Business Property City, State and Zip: *
Note assets owner/note payor Full Name:
Note assets owner/note payor Street Address:
Note assets owner/note payor City, State and Zip:
Business Name Now: *
Business Web Address:
Business Name Before Note: *
Business Age in Years: *
Business Type: *
Business Description: *
Business Sale and/or Note Transaction, By: *

Licensed Escrow/Title or Legal professionals. Buyer and Seller. Buyer, Seller and Legal professionals.
Business Franchise: *

Yes, and have Franchisor approval of Business Buyer. Yes, and do not have Franchisor approval of Business Buyer. No.
Business Sale Asset Values---EQUIPMENT. *
Business Sale Asset Values---INVENTORY. *
Business Sale Asset Values---GOODWILL. *
Business Sale Asset Values---REAL ESTATE. *
Business Sale Asset Value--INTELLECTUAL PROPERTY.
Business Sale Asset Value---ACCOUNTS RECEIVABLE: *
Business Premises Type: *
Business Premises Condition: *
Business Premises Ownership: *
# of Months Remaining on Existing Business Premises Lease
Business Premises Renewal Terms: *
Business Sale Transaction $ Amount: *
Business Sale Transaction Date: *
Business Sale Transaction Down Payment: *
Business Sale Down Payment in Cash: *

Yes No. (Explain the No Down Payment situation in COMMENTS section below.)
1st Lien/Note Original Principal Amount: *
2nd Lien/Note Original Principal Amount: *
3rd Lien/Note Original Principal Amount: *
Total of all Liens/Notes Original Principal Amount: *
Note Creation: *
Note Creation Date: *
Note for Sale Business Debt Position: *

1st Position 2nd Position 3rd Position
Note Current Principal Balance $ Amount: *
Note Interest Rate (If adjustable, explain in COMMENTS below): *
Note Terms: *
Current Note Payment $ Amount: *
Note Payment Period: *
Note Term in Months: *
1st Payment Due Date: *
Next Current Payment Due Date: *
# of Payments Made: *
# of Payments Remain: *
# Note Payments Late: *
Note Balloon Amount: *
Note Balloon Due Date: *
Note Payor Personal Guarantee: *

Yes, without defined or collateralized Assets outside the Business. Yes, with defined and collateralized Assets and documentation outside the Business. No
Description of Note Security: *
Note Payor Current Three Credit Scores *
Corporation/Partnership Credit Rating: *
Note Payor is a: *
Note Payor Operates the Business: *

Yes No
Note Payor Occupation: *
Is this a Simultaneous Business Sale and Note Sale? *

YES NO
Does the Business earn at least 2 times more Net Profit than the Note Payments Expense: *

YES NO
COMMENTS about Note, Business Property or Premises, Business, Payor or any other information you think we should know: *
Email or Fax your signed Note plus the Note securing property/assets Purchase/Sale Agreement to private@notefundingcenter.com Fax 888-642-3997. *

Yes No
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I have read and agree to the Privacy Policy *