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Mortgage Note Quote Request Form

Please fill out the following form in its entirety and as accurately as possible to ensure the highest quote. If you prefer you can simply download the form in PDF by clicking on this link, Fidelity Quote Request Form and either e-mail it to us at FidelityAmerica@aol.com or fax it back to us at: 585-227-1317.

It is Fidelity Home Buyers, USA policy that the broker must be working directly with the
note seller to obtain bid. No quotes from notes posted on web sites or from multi-brokers.

IF THIS IS A SIMULTANEOUS CLOSING PROPOSAL (THE NOTE HAS NOT YET BEEN CREATED) PLEASE CLICK THIS LINK, Fidelity Quote Request Form TO COMPLETE THE SIMULTANEOUS CLOSING FORM INSTEAD.

E-Mail Address :	*
First Name:
Last Name:
Phone:
Address:
State:
City:
Zip Code:
Property Address:	*
Type of Property:	*
Owner Occupied:	*
Property Description (If Commercial):
Position of Note:	*
Date of Sale:	*
Sales Price:	*
Down Payment:	*
Beginning Balance:	*
First Payment Due Date:	*
Original Term (Months):	*
Balloon Date (If Any):
Balloon Amount (If Any):
Current Balance:	*
Interest Rate:	*
P/I Payment Amount:	*
Payment Frequency:	*
Next Payment Due Date:	*
# Of Payments Made:	*
# Of Payments Remaining:	*
Credit Score:	*
Comments (Optional):
Fair Market Value (FMV):	*

(Fields marked with * are required)| Property Listings | Quote Form |