Genesis Financial, Inc.

Questionnaire


What type of cash flow are you interested in receiving a quote on? (select one)

Real Estate Note
Lottery
Structured Settlement
Annuity
Property Lease
Equipment Lease
Business Note
Royalty
Life Policy

If you have checked Real estate Note, please answer the following questions. If you have checked any other cash flow, please contact us at genesis@genesisfinance.com or toll free at 877-805-9169. All fields are required. If you are not sure place an X in the box.

What type of property is the note on? (residence, office building, land, restaurant, etc)

Where is it located?
City   State

Do the purchasers live or work in the property,
or is it rented or leased?

When did you sell the property?
Month
Year

What was the sales price? $


How much was the down payment? $

What is the balance owing on the note at this time?
$


What is the interest rate on the note? %

What is the payment amount? $


Does the payment stay the same throughout the term of the note? Is there an interest change? Is there a balloon payment? Describe any additional terms.



Have all the payments been made on time?
Yes No

Do you owe anything on the property?
Yes No
If so, how much? $

Please give us any additional information you think we should be aware of regarding this deal. (financial strength of the purchaser, condition of the property, etc)



Thank you. Simply click on the SUBMIT button below, and within 24 hours you will receive your quote.

Contact Name

E- mail Address






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Genesis Financial, Inc.