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Business Note Quotation Form

Note Holder's Name
Email Address
Contact Phone Contact Fax
Note Payor's Name
Payor's Email Address
Payor's Credit If Known Excellent     Good       Fair       Poor      Unknown
Is Payor in the Armed Forces? Yes     No If "Yes"...Deployed? Yes    No

Business Information Worksheet

Name of Business
Type of Business
Business Address
City, State, Zip
Business Sales Price Down Payment
Business Appraised Value Appraisal Date
Business Annual Revenue Annual Expenses
Net Operating Income Years in Business
Date Business Was Sold    
Is Business a Franchise? Yes    No Is Location Leased? Yes    No
If Leased, Explain the Renewal Options

Asset Valuation

  Leasehold Improvements  
Real Estate FMV if Business Property is Owned  
Additional Collateral?  Please Explain
Are Any of These Assets Encumbered? Yes     No  
Are There Any UCC-1 Security Filings? Yes      No  
If "Yes", What is the Date of Filing  
If "Yes", Who is the Secured Party?

Promissory Note Worksheet

Note's Lien Position First Position Second Position  
Original Note Balance Term of Note
Monthly Payment Interest Rate
Interest Rate is... Fixed Rate Variable Rate  
First Payment Date Is Note Current? Yes      No
Number of Payments Made Payments Remaining
Current Balance    
Is There a Balloon? Yes    No If "Yes", Balloon Date
    Balloon Amount
Is There a Personal Guarantor? Yes    No  
If so, Guarantor's Name
Additional Quote Request Information
Please Do the Math   8+4  =