Lakeshore Mortgage Note Evaluation Request Form
Lakeshore Mortgage Services, Inc.

Note Evaluation Request Form
To find out how much money we can pay you and how the process works, take 5 minutes to fill in and submit the information sheet below. We will call you the same or next business day with answers to all of your questions or call us toll free at (800) 999-3430 from 7:30 AM to 5:00 PM, Pacific Coast Time, to question us about our programs.

The information requested below is the minimum necessary for evaluation of your note.

What type of real estate instrument do you want to sell? (Pick One)
Mortgage
Note & Deed Of Trust (Trust Deed)
Real Estate Land Contract (Contract For Deed/Sale Agreement)
Original Face Amount:
Present Balance: As Of What Date?
Interest Rate: % Remaining Term:
Please fill in applicable amount based on payment frequency.
Monthly Payments:
Quarterly Payments:
Semi-Annual Payments:
Annual Payments:
Balloon Payment: Balloon Date:
Date First Payment Was Made:
Total number of payments made to date:
Number of payments remaining:

Now about the property...
Selling Price: Down Payment:
Sale Date:
Property Location:
Current Property Value:
Property Type (Select One):
Owner Occupied?    Yes No
Property Size (Select One):
Lien Position of Your Note
or Contract (Select One):
Your estimated cash
requirements:
You may not need to sell the entire note...
when a partial sale will meet your needs!
Additional Information / Comments:

Thank you for the opportunity to evaluate your note.
We will respond to you shortly!
Your Name
(First & Last):
Your Street Address:
Your City: State: Zip Code:
Your Phone Number:
(Include Area Code)
Your E-mail Address:

Please be sure that you have filled in
all of the blanks and marked all options.

Submitting this form will automatically email your responses to us and you
will see a page displaying your responses. Then, to return to our Home Page,
just click the link at the end of your displayed information.

Thank you.


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