Hard Money Lending by WN Funding

* Denotes Required Field.

Name of the Note Owner:*

Note Owner’s Telephone:

Broker’s Name:

Broker's Telephone:

Best Time to Call:

How did you hear about WN Funding?*

Note Owner’s Mailing STREET Address: *

Note Owner’s Mailing CITY, STATE and ZIP: *

Voice Phone: *

Fax:

Your Relationship to Note: *

Note Property STREET Address: (if applicable)*

Note Property CITY, STATE and ZIP: (of applicable)*

Type of Note Property: *

Property Condition: *

Land included in all Notes, Mortgages and Liens: *
Yes
No

The Land is:

The Note Property Layout (# of Bd, Baths, Sq.Ft.of Bldgs, Lot size):

Property Age in # of Years: *

Property Location: *

Property Sale Price: *

Cash Down Payment Amount: *

Property Sale Date: *

Certified Appraisal Amount:

Note Original Principal Amount: *

Total of ALL Existing Liens/Notes Original Principal Amounts: *

Note Payor Occupies the Property: *
Yes
No

Note Position: *

Current Principal Balance of Note: *

Note Interest Rate: *

Note Terms: *

Note Payment Period: *

Note Payment Amount. (If Variable or Unequal, describe in COMMENTS Below): *

Note Term in Months: *

1st Payment Due Date: *

Next Payment Due Date: *

# of Payments Made: *

# of Payments Remain: *

Balloon Amount: *

Balloon Date: *

Note Security: *

Note Payor is a: *

Individual Note Payor Current, Middle Credit Scores or Corp Payor Credit Rating:

If this is a Commercial Property Real Estate Note, the Guarantor is: *

Are you Simultaneously selling the Note Property and this Note? *
Yes
No

COMMENTS about Note, Property, Payor or any information we should know that's not asked above: *