Contact Us Name(Required) First Last Email(Required) Phone(Required)Exact Business Name(Required) Type of Business Asset Value BreakdownEquipmentInventoryGoodwillAdditional Collateral and its Value:Was there a signed Security Agreement with UCC-1 recorded at the time of note creation?YesNoAnnual Revenue of Business:Annual Net Operating Income:Is operation a franchise?YesNoProperty Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code How many years in business at this location? *1234567891011121314151617181920Business Location is:Owned by PayorLeased by PayorQualifications of Payor to operate this business: *(Required)Is the Note personally guaranteed?YesNoHISTORICAL INFORMATIONDate MM slash DD slash YYYY Sales PriceDown Payment:Are there any liens or underlying loans agains the business? (SBA, other bank, etc.)YesNoNote Information Term in months:Original Note Amount:Payment Amount:Balloon Amount:Date MM slash DD slash YYYY Interest Rate:Due Date of First Payment: MM slash DD slash YYYY Number of payments made:1234567891011121314151617181920Number of payments left:Next payment due date: MM slash DD slash YYYY Current Balance:Why do you want to sell the note?Other comments:How did you hear about ELM Capital?Please select oneRefferred by any another personGoogle SearchFacebookDirect MailBing or Yahoo SearchOther
