BUSINESS INFORMATION
Name of Business
Type of Business
Primary Location Address
Address 2
Primary Location City
Primary Location State
Primary Location Zip Code
Brief Description of Primary Location
Is the Primary Location?:	Owned by Payor Leased by Payor
If Leased, Date Lease Expires
Terms of Lease Renewal Option, if any
How long has the business been in this Location?
Is the operation a Franchise?	Yes No
If 'Yes', has franchisor committed to cooperate with note buyer in event of a foreclosure or resale?	Yes No
Information on the Sale of the Business
Date of Sale
Sales Price	$
Down Payment	$
First Lien	$
Second Lien	$
Current Breakdown of Assets
Equipment	$
Land & Buildings	$
Inventory	$
Accounts Receivable	$
Goodwill	$

Information on Note Being Sold
Position of the Note	First Second
Current Balance on Note	$
If 2nd: Current Balance on 1st Note	$
Date of Note
Original Value of Note	$
Original Term of Note
Interest Rate on Note	%
Frequency of Payment	Monthly Quarterly Annual Other
If OTHER, describe
Amount of Payment	$
Date of First Payment
Are Payments Current	Yes No
Date of Last Payment
Number Payments Made Thru Last Payment
Number Payments Remaining After Last Payment
Date Next Payment Due
First Date to Include in Quote
Number Payments to Price in Quote
Is There a Balloon Payment?	Yes No
If Balloon Payment = YES
Amount of Balloon	$
Balloon Date Due

Information on Buyer (Payor of Note)
If Payor is a corporation or other business entity, is there also a creditworthy individual liable for the payments?	Not Applicable, Individual Purchaser with Personal Guarantee Yes No
If 'Yes', Please give name.
Have any of last 12 payments (or all if less than 12) been 30 days late	Yes No
If YES # of late payments
Please briefly describe the qualifications the payor has to operate this business.
If you ran a credit report or feel qualified to give an opinion, where would you rate your buyers credit?	Exceptional Above Average Average Below Average

Miscellaneous Information
Which quote(s) would you like to receive?	Full Buyout Partial Buyout Both
If Partial or Both, How much would you like to receive now?	$
For Business Notes we also need a copy of the note You can fax it to (303) 646-1907 or email it to steve@storyfinancial.com