Note Auction - The Leading Buyer of Notes Nationwide

A Note Request Form
* Required Fields

* Your Name:

* Your Email:

* Your Day Phone:

Your Home Phone:

* Original Receivable Amount:

* What is the appraised value of collateral or security for the Note/Receivable?

* If no appraisal, what is your estimate?

* What is the balance owed today?

(estimate if not certain)

* When was the date of first payment?

(estimate if not certain)

* How are payments received?

(monthly, amount, etc.)

* What type of receivable is this?

(note, 1st, 2nd, lottery, etc.)

Are there any lump sum payments.

Yes, if yes. How much? (estimate if not certain)

If Lump Sums, when are these lump sums due?

Payment Amount:	Payment Date:
	1st Payment
	2nd Payment
	3rd Payment
	4th Payment
	5th Payment

Comments:

You are sending this information to us so that we can get you an estimated amount to expect should you desire to sell or auction this receivable. You nor us are under any obligation whatsoever until such time a written mutually agreeable contract is signed.

By providing NoteAuction.com with the above information you are giving us the permission and authority to share this information with prospective buyers.

If you have any questions, please contact us info@noteauction.com

Phone: (406)284-3486
Fax: (406)284-6678
info@noteauction.com