Note Submission Form - Reliant Note Services

Please fill out the form below with as much detail as you can. The more information you provide, the more accurate and competitive your quote will be. Once we’ve had a chance to review your submission and do some light due diligence, we’ll get back to you within 48 hours—often sooner! No pressure, no obligation—just a straightforward review of your note and what we can offer.

Step 1 of 3 - Note Owner Information

Full Name*
Text Friendly Phone Number*
SMS Optin
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Email*
Are you the sole owner?*
What is your motivation for selling this Note?*

Asking Price*
Original Note Value*
Date Written*
Down Payment*
Unpaid Balance*
Back Interest
Late Charges & Fees Due
Balloon? When is it due?
Lien Position*
Pay History (eg. how many months or years) / Is it current?*
Who is servicing the Note?*
Rate & Terms (eg: 6% for 30yr Fixed)*
Note Type (eg: Amortized, Simple, Interest Only, etc)*
Monthly Payment (P&I only)*
Please list Underwriting Documentation Available (Recorded Deed, Borrower ID/Passport/Citizenship, Credit/Background Check, Income Statements/Tax Returns/Paystubs, Servicing Records, Original Property Insp. Report, Title Policy, Insurance Binder, etc)*

Property Address*
City*
State*
Zip Code*
Current Market Value*
What are you basing the current market value from? (Zillow, Appraisal, etc)*
Property Style*
No. of Bedrooms*
No. of Bathrooms*
Garage/Parking and # of cars (eg: 1-2-3, etc., attached, detached, carport, etc)*
List Rooms (Family, Recreation, Den, Office, Dine, Loft, Sun, etc.)*
Outbuildings (eg: Shed, Barn, Dogpen, etc.)*
Heating (eg: Forced Air - Gas, Forced Air - Electric, Wood stove, Fireplace, Solar, Electric Baseboard, etc)*
A/C (eg: None, Central, Windows, etc)*
Hot Water / Installation Date if known (eg: Tank, On demand, Natural Gas, Electric)*
Basement Type (eg: None, Crawl, Partial, Walkout, Full)*
Full Basement Finishing (eg: unfinished, partial, full)
Main Square Feet*
Lot Size*
Property Taxes*
Year Built*
Year Remodeled?
Overall Condition*
Is there anything else we need to know about the note or the property that hasn't already been addressed?*
Name
This field is for validation purposes and should be left unchanged.