Land Contract Buyer

Type of Instrument: Select One Note & Mortgage Note & Mortgage Deed Note & Deed of Trust Note & Trust Deed Land Contract Contract for Deed Other

Type of Property: Select One Single Family Residence Multi-Family 2-4 units Multi-Family 5 or more units Commercial Land Other

Property Description:

Property Address:

If Property is Commercial; Current Use and Special Features:

If Property is Land; Public Road Frontage and Special Features:

Sale Date:

Sale Price:

Cash Down Payment:

Original Balance:

Owner Occupied or Operated? Select One Yes No Not Sure

Do You Own a Lender’s Policy of Title Insurance? Select One Yes No Not Sure

Interest Rate:

Payment Amount:

First Scheduled Payment Date:

Final Scheduled Payment Date:

Current Balance:

Through What Payment Date:

Number of Late Payments Received: Select One None 1 2 3 4 5 or more

The Borrower is a: Select One Private Individual Business Entity (Corporation, LLC, Trust, etc.) Business Entity with Personal Guarantee

The Borrower's Credit Score will be: Select One Excellent Good Average Poor

Your First Name:

Your Last Name:

Your Address:

Telephone:

Email:

Additional Comments:

How did you hear about the The Land Contract Buyer website? Select One Search Engine Recommended by a Friend Other

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