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Land Note
Your Information
Title
Mr.
Mrs.
Miss.
Ms.
Dr.
Other
First Name
Last Name
Email
Phone #
(include area code)
Are you personally receiving payments from this?
Yes
No
Note Balance
Your note will not be considered with web addresses or solicitations!
Comments
Note Information
Note Category
$0 to $50,000
$50K to $200K
$200K +
Payors Credit
A - 700 and above
B - 670 to 700
C - 630 to 670
D - 600 to 630
Below 600
Unknown
Property Value
Owner Occupied
Yes
No
How is the Property Zoned
Residential
Commercial
Agricultural
Other
Is the Property Located in a Subdivision
Yes
No
Size of the Property
Structures on the Property
Yes
No
Where is it Geographically (mountains, hills, beachfront, etc.)
Plans for this Property
Is there Road Access
Yes
No
Is there a Paved Road
Yes
No
Are there Curbs and Sidewalks
Yes
No
Is there Electricity
Yes
No
Is there Sewer and Water
Yes
No
Are there Phone Lines
Yes
No
Is there Cable and Internet
Yes
No
Sales Date
January
February
March
April
May
June
July
August
September
October
November
December
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02
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Sales Price
Down Payment
State
Please Select a State
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Outside United States
City
Face Value of Note
Interest Rate
Note Balance
Payment Amount
Payments Made
Monthly
Quarterly
Semi Annually
Annually
Other
# of Payments Made
When 1st Payment was Made
January
February
March
April
May
June
July
August
September
October
November
December
01
02
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Payments Remaining
Next Payment Due Date
January
February
March
April
May
June
July
August
September
October
November
December
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02
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Loan to Value (%)
Payment Status
Current
Delinquent
Balloon Payment
Yes
No
Size of Balloon Payment
Date of Balloon Payment
January
February
March
April
May
June
July
August
September
October
November
December
01
02
03
04
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Position of Note
1st
2nd
3rd
other
1st Remaining Balance
2nd Remaining Balance
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