Nationwide Financial Corporation

Request for Quote:
Please fill in the information below, and we will provide you with a quote to purchase.

Your Name:

Company Name:

Phone Number:

Fax Number:

Email Address:

Transaction Status: Listing Earnest Money Closed

Sellers Name:

Legal Description or Tax ID#:

Property Type: Single familyLandCommercial Multi-FamilyMobile Home/Land

Position: 1st.2nd3rd Wrap Around

Sale or Est. Closing Date:

Sales (List) Price:
$

Down Payment:
$

Current Note Balance:
$

Interest Rate:
%

Payment Amount:
$ MonthlyQuarterlySemi-AnnualAnnual

Balloons (Dates & Amounts):


Other loans against property:
Balance: $
Interest: %
Payment: $

Balloons (Dates & Amounts):

Immediate Cash Needs:
$
If cash needed is less than the full cash value of the note we can offer a partial purchase option.

Authorization To Release Information: (If your note is paid through an Alaska bank or escrow company.)
By giving us the following information, we can obtain all information needed to provide you with a Purchase Offer.
Name of Bank or Escrow Company:

Payor's Name:

Escrow Account Number:

I hereby authorize the above bank or escrow company to release the following information concerning my escrow account to CA$H NOW Financial Corporation.

I confirm this authorization by listing the last 4 digits of my Social Security Number:


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