1. File/ Guaranty No: ______________________________________
2. Transaction Name: ______________________________________
3. Land Location: ______________________________________
4. Land use: (describe)
____ Apartments - __________________________________________________
____ Hotel/ Motel - __________________________________________________
____ Industrial - __________________________________________________
____ Manufacturing - __________________________________________________
____ Office - __________________________________________________
____ Shopping Center - __________________________________________________
____ Restaurant - __________________________________________________
____ Retail - __________________________________________________
____ Vacant Land - If yes, intended use - __________________________________
____ Other - __________________________________________________
5. Structure of Transaction (of both sale and finance, if applicable):
____ Deed in lieu of foreclosure What consideration being given? _________________________
____ Conveyance to lender or entity related to lender What consideration being given? __________________________
____ Leveraged buyout What consideration being given? ___________________________
____ Stock purchase or purchase of part or all of partnership interest
What consideration being given? _____________________________
____ Sale of real property asset between parties What consideration being given? _____________________________
____ Purchase money mortgage
____ Any other use of fund If yes, please describe. _________________________________
____ Construction of mortgage Are there draws? ____ If yes, who is disbursing? ____________
____ Refinance
If yes, refinancing what debt? _____________________________ Any additional debt? ________
____ Mortgage modification
____ Mortgage securing antecedent debt
____ A mortgage of partnership assets to pay partner(s)
____ A mortgage of corporate assets to pay stockholder(s)
____ Upstream financing
____ Cross-stream financing
____ Downstream financing
____ Recapitalization of a corporation or the entity
____ A guarantee or indemnity mortgage
____ An arm’s length transaction for reasonably equivalent value
____ Title coming through a mortgage foreclosure
If you have checked any of the above choices, please describe the transaction more fully here:
____________________________________________________________________________________
____________________________________________________________________________________
Will the mortgage contain any cross-collateralization or cross-default provisions? _____________
Will the mortgage secure the debt of any person or entity other than the mortgagor? _____________
Please describe the transaction(s) indicated by this questionnaire fact sheet in as much detail as possible and please include a flow chart if available (use and indicate additional page(s) if necessary): ______________________________________________________________________
6. Creditors:
What is the current total amount of unsecured creditors—trade payables, all accounts payable? __________
Please attach a list of accounts payable or other evidence.
7. Parties to Transaction:
Name of buyer ____________________________________________
Name of seller ____________________________________________
Name of lender ____________________________________________
What type of entity is seller? _____________________ Is it publicly traded? _____________
If not publicly traded, what is the telephone number of trader? _____________ and,
address for seller ____________________________________________
What type of entity is buyer/ borrower? ______________________ Is it publicly traded? _______
If not publicly traded, what is the telephone number of buyer/ borrower? _____________ and,
address for buyer/ borrower ____________________________________________
Will selling/ conveying entity survive this transaction or will it dissolve? _____________
Is the selling/ conveying entity merging into the buyer? _____________
Is the seller related, in any way, to buyer (e.g. common owners, multiple dealings, etc.)? _____________
Is the seller related, in any way, to lender (e.g. common owners, multiple dealings, etc)? _____________
Is the borrower related, in any way, to lender (e.g. common owners, multiple dealings, etc.)? ___________
Is this the seller’s only asset, or substantially all of seller’s assets? _____________
Is this the borrower’s only asset, or substantially all of borrower’s assets? _____________
Is the borrower a single purpose entity? _____________
Is the seller, or any of them, currently in bankruptcy? ______________
Does the seller, or any of them, contemplate or anticipate any bankruptcy proceeding? ______________
Are seller’s financial statements available? ______________ Are they audited? ______________
Are buyer/ borrower’s financial statements available? ______________ Are they audited? ______________
Is the buyer/ borrower, or any of them, currently in bankruptcy? ______________
Does the borrower, or any of them, contemplate or anticipate any bankruptcy proceedings? ______________
Is borrower profitable______________? Explain _____________________________
Is borrower solvent, excluding good will? ______________ Explain _____________________________
9. Purchase price is: ______________________
The purchase price is being paid as:
____ cash to seller
____ part cash/ part other consideration (loan, stock, etc.)
____ all consideration is other than cash (loan, stock, other property(ies), etc.)
Amount of seller’s outstanding indebtedness, secured by this property: ____________
Purchase price was determined by:
____ Appraisal Has a copy been provided to company? ____
____ Negotiation
____ Other (describe) __________________________________________________
10. New loan amount is: ______________ Value of land: _____________ Value of all collateral is: ____________
Amount of borrower’s outstanding indebtedness, secured by this property: ______________________
Original loan amount for borrower’s outstanding indebtedness: ______________________
Payment amount under current indebtedness: ______________________
Payment frequency under current outstanding indebtedness: ______________________
Payment amount under new loan: ______________________
Payment frequency under new loan: ______________________
Terms of loan: ______________________
New loan amount was determined by:
____ Appraisal Has copy been provided to company? ____
____ Negotiation
____ Other (describe) ________________________________________
Value of the collateral was determined by:
____ Appraisal Has copy been provided to company? ____
____ Negotiation
____ Other (describe)
Loan-to-Value ratio: ______________________
What is debt service coverage ratio? ______________________
Any Guarantees? ______________________ Explain ______________________
Is guarantee general or for carveouts? ______________________
Any bankruptcy saving clause? ______________________ Explain ______________________
11. Sources of funds for transaction: ______________________
Equity contribution: ______________________
Any allocation of funds to particular properties: ______________________
12. Disbursement and use of funds: ______________________
Are there written instruction as to the payment of the net sales proceeds to seller? ____________________
Funds from seller’s net proceeds (reflected in an overall percentage) are going to:
____ Seller to pay purchase price
____ Seller’s lender to pay off loan, secured by this property
____ Pay seller’s existing Creditor’s which are not secured by this property
____ Other party or entity, related to seller (explain) ____________________
____ Other (explain) ______________________________________________
Is this a refinance with the loan proceeds paying off existing loan 100% with no excess funds? ____
(If there are excess loan proceeds how are they being disbursed and used?)
Are there written instructions as to the payment of the new loan proceeds to borrower? ____
Funds from borrower’s loan proceeds (reflected in an overall percentage) are going to:
____ Seller to pay purchase price Amount: ____________
____ Seller’s lender to pay off loan, secured by this property Amount: ____________
____ Pay seller’s existing Creditor’s which are not secured by this property Amount: ____________
____ To, or for benefit of, other party or entity, related to seller (explain) Amount: ____________
____ Borrower, for borrowers benefit Amount: ____________
____ Borrower’s lenders to pay off loan, secured by this property Amount: ____________
____ Pay borrower’s existing Creditors, which are not secured by this property Amount: ____________
____ To, or for benefit of, other party or entity, related to borrow (explain) Amount: ____________
____ Other (explain) ______________________________________________
Please provide copies of loan document, appraisals, income statements and balance sheets if applicable.
Please describe how the funds from this transaction (either sales process, purchase money or loan proceeds are being used (use and indicate additional page(s) if any are necessary):
_______________________________________________________________________________________________________________
Additional information that is, or may be, pertinent to the review of the Creditors’ Rights Coverage (use and indicate additional page(s) if necessary):
_______________________________________________________________________________________________________________
(If signed by seller/transferor or buyer/mortgagor)
The undersigned represents that:
(A) The signer is authorized by the seller/transferor and/or buyer/mortgagor, as applicable, to sign this questionnaire on their behalf, respectively, and
(B) The foregoing statements are true and complete and acknowledges that Stewart Title Guaranty Company will rely upon the statements made herein to amend the coverage of the title insurance policy(ies) to be issued in connection with the above transaction(s).
Signature: _________________________________
Print Name: _________________________________
Print Title: _________________________________
Entity Name: _________________________________
Address: _________________________________
_________________________________
Phone: _________________________________
State of _________________ )
) §§
County of _________________ )
Sworn to and subscribed before me by _____________________________________, _______________________________ of __________________________________________ on this _______ day of __________________, 200__.
__________________________________
Notary Public
My Commission Expires: _____________
__________________________
Note: This Acknowledgment should be copied and completed for each signer.
Copyright 1970-2024 Stewart Title Guaranty Company. All rights reserved. The use of this form (or any derivative thereof) is restricted to Stewart Title Guaranty Company, its issuing agents, and affiliates in good standing as of the date of use. All other uses are prohibited.
For issuing guidelines on this form, see Guidelines.