MIQ

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Mortgage Information Questionnaire

Rep Name____________________________ Phone_______________Fax______________

Is this a Simultaeous Closing? YES NO (please circle one)

NOTE SELLER INFORMATION

Name_________________________________Phone_______________Fax_____________

Address_______________________________City__________State___________Zip____

MORTGAGOR INFORMATION

Name_________________________________SSN________________________

Address_______________________________City__________State___________Zip____

PROPERTY INFORMATION

Property Type:

Single-family Detached House # of bedrooms_____ # of bathrooms____

Multi-family Unit # of Units____________

Condo

Commerial Building Use_____________________________________________

Mobile Home with Land Year built_____# of bedrooms____# of bathrooms_______

Single-wide or Double-wide

Lot: Commercial or Residential # of acres__________

OCCUPANCY

Ownr Occupied Tenant Occupied Vacant

Sale Date_________________________________Sale Price________________________

Terms: # of Years_________________Down Payment_____________Interest________

Monthly Payment________________(principal and interest only)

First Payment Due________________

# of Payments made_______________ # remaining_______________

Beginning Balance________________ Current Balance______________

Does the NOte Balloon?___________ If so, when___________________

LIEN POSITION

1st Mortgage 2nd Mortgage** Wrap Mortgage

**If the note is a second mortgage, what was the balance of the first at the time of sale?

___________________________

GEOGRAPHY

Urban Suburban Fringe Inner City Rural

I hereby certify that to the best of my knowledge, the above information is true and correct. Please give me a purchase quote on my note. I understand that I am under no obligation to sell. I also undestand that if any of the above information is found to be inaccurate and/or any other information is found to effect the true quality of the note, the final purchase price may be diffrent from my quote. After all the information is verified please notify me of my final purchase price. I will then decide if I am going to sell my note.

______________________________________________________

Note/Mortgage Holder Signature

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	Cut Along This Dotted Line ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Mortgage Information Questionnaire Rep Name____________________________ Phone_______________Fax______________ Is this a Simultaeous Closing? YES NO (please circle one) NOTE SELLER INFORMATION Name_________________________________Phone_______________Fax_____________ Address_______________________________City__________State___________Zip____ MORTGAGOR INFORMATION Name_________________________________SSN________________________ Address_______________________________City__________State___________Zip____ PROPERTY INFORMATION Property Type: Single-family Detached House # of bedrooms_____ # of bathrooms____ Multi-family Unit # of Units____________ Condo Commerial Building Use_____________________________________________ Mobile Home with Land Year built_____# of bedrooms____# of bathrooms_______ Single-wide or Double-wide Lot: Commercial or Residential # of acres__________ OCCUPANCY Ownr Occupied Tenant Occupied Vacant Sale Date_________________________________Sale Price________________________ Terms: # of Years_________________Down Payment_____________Interest________ Monthly Payment________________(principal and interest only) First Payment Due________________ # of Payments made_______________ # remaining_______________ Beginning Balance________________ Current Balance______________ Does the NOte Balloon?___________ If so, when___________________ LIEN POSITION 1st Mortgage 2nd Mortgage Wrap Mortgage If the note is a second mortgage, what was the balance of the first at the time of sale? ___________________________ GEOGRAPHY Urban Suburban Fringe Inner City Rural I hereby certify that to the best of my knowledge, the above information is true and correct. Please give me a purchase quote on my note. I understand that I am under no obligation to sell. I also undestand that if any of the above information is found to be inaccurate and/or any other information is found to effect the true quality of the note, the final purchase price may be diffrent from my quote. After all the information is verified please notify me of my final purchase price. I will then decide if I am going to sell my note. ______________________________________________________ Note/Mortgage Holder Signature ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Cut Along This Dotted Line