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	Equipment
	Inventory
	Leasehold Improvements
	Goodwill
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 =

Business Information Worksheet