Business Note Worksheet

Seller's Information:
Seller's Name:
Phone:
Address:
City:
State:
Zip Code:

Payor's Information:
Payor's Name:
Phone Number:
Current Address:
City:
State:
Zip Code:
Prior Address :
City:
State:
Zip Code:
Social Security:
If Payor is a corporation, is there also a creditworthy individual liable for payments?
  Yes No
Individual's Name:
Current Address:
City:
State:
Zip Code:
Prior Address:
City:
State:
Zip Code:
Social Security:

Co-Payor's Information:
Co-Payor's Name:
Phone Number:
Current Address :
City:
State:
Zip Code:
Prior Address:
City:
State:
Zip Code:
Social Security:

Business Information:
Type of Business:
Asset Value Breakdown
Equipment: $
Inventory: $
Goodwill: $
Is operation a Franchise?
  Yes No
If yes, has Franchisor committed to cooperate with Note Buyer in the event of foreclosure/resale?
  Yes No
Address:
City:
State:
Zip Code:
County:
How long in business at this location?
 
Business Location is:
  Owned by Payor
Leased by Payor
If Leased by Payor, when does it expire:
 
Give terms of any lease renewal option(s):
Qualifications of Payor to operate this business:

Description of business location and area:

Historical Information:
Date of Sale:   
Selling Price: $
Down payment: $
First Lien: $

Note Information:
Date of Note:   
Amount: $
Term in Months:   
Payment Amount: $
Balloon Amount: $
Interest Rate:   
Due Date First Pmt:   
# of Payments Paid:   
# of Payments Left:   
Next Payment Due:   
Balance: $

Motivation Information:
Why does seller want to sell?
How much of the note does seller wish to sell?
If we can't buy the whole note, how much money would solve the seller's problem?

Your Contact Information (Needed so that we may contact you with purchase offers)  
Your Name:
E-mail: (Required OR tel #)
Phone Number: (Required)
Fax:
Address:
City:
State:
Zip Code: