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\nowidctlpar\faauto\adjustright\rin0\lin0\itap0 \fs20\lang1033\cgrid \snext0 Normal;}{\*\cs10 \additive Default Paragraph Font;}}{\info{\title Equipment Note Submission Worksheet}{\author Karen Knott}{\operator George Karl}
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\b\f1\fs26 Equipment Note Submission Worksheet}{\f1\fs24 
\par }\pard \nowidctlpar\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs24 
\par }\pard \sl360\slmult0\nowidctlpar\tldot\tx4680\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 CCFC/Broker Information
\par }\pard \nowidctlpar\tlul\tx6739\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Name\tab  Date\tab 
\par }\pard \nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Company\tab \tab 
\par Address \tab \tab 
\par }\pard \nowidctlpar\tlul\tx4680\tlul\tx6480\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 City\tab State ____________ ZIP\tab 
\par }\pard \nowidctlpar\tlul\tx4680\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Phone \tab  Fax\tab }{\b\f1\fs22 
\par }\pard \nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 
\par }\pard \sl360\slmult0\nowidctlpar\tldot\tx4680\tx5040\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 Equipment Information}{\f1\fs22 
\par }\pard \nowidctlpar\tlul\tx4680\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Type of equipment (Description, year, make, model) \tab \tab \tab 
\par }\pard \nowidctlpar\tlul\tx4680\tx5220\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Market value $\tab  Basis of value\tab 
\par }\pard \nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Location address \tab \tab 
\par }\pard \nowidctlpar\tlul\tx4680\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 County\tab  City _____________ State\tab 
\par }\pard \nowidctlpar\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Type of security instrument:     }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22 
 Security agreement     }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1  }{\f1\fs22  Lien on title    }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22 Chattel mortgage

\par }\pard \nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22   }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22 Other (describe) \tab  
\par }\pard \nowidctlpar\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 If payor is a corporation, is there also a creditworthy individual liable for payments?  
\par }\pard \nowidctlpar\tlul\tx9187\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22    }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22 No        }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings"
 \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes (name)\tab  
\par Describe equipment usage\tab 
\par Describe any leasing activity\tab 
\par }\pard \nowidctlpar\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 
\par }\pard \sl360\slmult0\nowidctlpar\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 Historical Information                                       \tab           Details of Original Sale }{\f1\fs22 
\par }\pard \nowidctlpar\tx2160\tlul\tx4680\tx5220\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Date of sale\tab   \tab    \tab \tab 
\par Selling price\tab $\tab \tab \tab 
\par Down payment\tab $\tab \tab \tab 
\par First lien \tab $\tab \tab \tab 
\par Second lien \tab $\tab \tab \tab 
\par }\pard \nowidctlpar\tx2160\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 
\par }\pard \sl360\slmult0\nowidctlpar\tx2160\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 Note Information}{\f1\fs22  \tab                                                    }{\b\f1\fs22 Payor Information}{\f1\fs22 

\par }\pard \nowidctlpar\tx2160\tlul\tx4680\tx5220\tlul\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Date of note\tab   \tab \tab  (Employment info, payment history,
\par Amount \tab $\tab \tab  SSN)\tab 
\par Term in months\tab   \tab \tab \tab 
\par Payment amount \tab $\tab \tab \tab 
\par Balloon amount\tab $\tab \tab \tab 
\par Balloon date\tab   \tab \tab 
\par Interest rate\tab   \tab %
\par Due date 1st pmt\tab   \tab \tab  }{\b\f1\fs22 Seller\rquote s Motivation/Need}{\f1\fs22 
\par # of pmts paid\tab   \tab \tab \tab 
\par # of pmts left\tab   \tab \tab \tab 
\par Next pmt due\tab   \tab \tab \tab 
\par Balance\tab $\tab \tab \tab 
\par }\pard \nowidctlpar\tx2160\tldot\tx4680\tx5220\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 
\par 
\par }\pard \nowidctlpar\tx2160\tldot\tx4680\tx5392\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\b\f1\fs22 Quote                                                                   \tab }{\i\f1\fs22 I have copies of the following:}{\b\f1\fs22 
\par }\pard \nowidctlpar\tx2160\tldot\tx4680\tx5392\tx7732\tx8632\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 \tab                                           \tab Note\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings"
 \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  No
\par }\pard \nowidctlpar\tx2160\tlul\tx4680\tx5392\tx7732\tx8632\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22 Buy Total Note\tab $\tab \tab Security instrument\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt
\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  No
\par Buy _____ pmts for \tab $\tab \tab Title\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22 
 No Buy _____ pmts for\tab $\tab \tab Sales contract\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{
\f1\fs22  No
\par Date of quote\tab   \tab \tab Payor credit report\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{
\f1\fs22  No
\par Closing costs paid by   \tab \tab Closing statement\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{
\f1\fs22  No
\par }\pard \nowidctlpar\tx2160\tx5392\tx7732\tx8632\tldot\tx9187\tx10800\faauto\adjustright\rin0\lin0\itap0 {\f1\fs22                     \tab \tab Bill of sale\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{
\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  No
\par \tab \tab Insurance\tab }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  Yes\tab  }{\f1 {\field{\*\fldinst SYMBOL 111 \\f "Wingdings" \\s 10}{\fldrslt\f14\fs20}}}{\f1   }{\f1\fs22  No}{\f1\fs24 
\par }{\f1 /equipnot}{\f1\fs24 \tab \tab }{
\par }}