Aerospace DELMarVA Judgment Services

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Aerospace Note Worksheet
*Bold fields are required.*
*Name:*
*Work#:*
Fax#:
Cell#:
*Home#:*
*Best Time to Call:*
*How Did You Hear of Us:?*

*Email:*
*Note Balance:$*
*Interest Rate:%*
*Purchase Date:*
*Down Payment:$*
*Payment Amount:$*
*Payment Made:*
*# of Payments Made:*
*# of Payments Remaining:*
*Payment Status:*
*Position of Note:*
*Is Aircraft Leased:?*
*Type of Security Instrument:*
*Type of Aircraft:*
*Aircraft Primarily Used For:*
*Registration #:*
*Condition:*
*Year:*
*Market Value:$*
*State:*
*Airport Location:*
*Immediate Cash Needed:$*
*Comments:*	How can we help you?
The data, which we collect from you is not an application for credit. The intent of this form is for us to determine if a relationship between DELMarVA Judgment Services and/or its assigns and you and/or your company would be mutually beneficial. By submitting the required form, you authorize DELMarVA Judgment Services and/or its assigns to access any credit reporting agencies for which we are a member in your security interest under any agreements and transactions relating to DELMarVA Judgment Services and you and/or your firm. Your information is held in the strictest confidence and is used to help you achieve your goals in an expeditious and professional manner. ____________________________________________ Do you have these documents? (check all that apply):
Note:
Security Agreement:
Title:
Sales Contract:
Payor Credit Report:
Buyer/Seller Agreement:
Bill of Sale:
Insurance:
Airworthiness Certificate: