$val) {
$_POST[$key]=stripslashes($_POST[$key]);
# echo ereg_replace('_',' ',$key) . ' $_POST[\'' . $key . '\']' . "
\n";
}
}
if ($_POST['Submit']) {
if (preg_match(' /[\r\n,;\'"]/ ',$_POST['email'])) {die("Please Don't do that again.");}
if (preg_match(' /[\r\n,;\'"]/ ',$_POST['Address'])) {die("Please Don't do that again.");}
$recipient[]='hhengl@westernfinancialaz.com';
# info@westernfinancialaz.com
$subject="Business Note Information Request Form";
$message='
Name: ' . $_POST['realname'] . '
E-mail: ' . $_POST['email'] . '
Address:
' . $_POST['Address'] . '
' . $_POST['City'] . ' ' . $_POST['State'] . ' ' . $_POST['Zip'] . '
Daytime Phone: ' . $_POST['Daytime_Phone'] . '
Evening Phone: ' . $_POST['Evening_Phone'] . '
Best time to contact: ' . $_POST['Best_time_to_contact'] . '
Business Type: ' . $_POST['Business_Type'] . '
Business Name: ' . $_POST['Business_Name'] . '
Business Address: ' . $_POST['Business_Address'] . '
Age of Business: ' . $_POST['Age_of_Business'] . '
How long at current address: ' . $_POST['How_long_at_current_address'] . '
How long did you own the business: ' . $_POST['How_long_did_you_own_the_business'] . '
Qualifications of Payor: ' . $_POST['Qualifications_of_Payor'] . '
Is there also a creditworthy individual liable for payments?: ' . $_POST['Is_there_also_a_creditworthy_individual_liable_for_payments?'] . '
Payor Name: ' . $_POST['Payor_Name'] . '
Payor SS#: ' . $_POST['Payor_SS#'] . '
Payor Address: ' . $_POST['Payor_Address'] . '
Payor City: ' . $_POST['Payor_City'] . '
Payor State: ' . $_POST['Payor_State'] . '
Payor Zip: ' . $_POST['Payor_Zip'] . '
Description of Business location and surrounding area: ' . $_POST['Description_of_Business_location_and_surrounding_area'] . '
Date of Sale: ' . $_POST['Date_of_Sale'] . '
Sales Price: ' . $_POST['Sales_Price'] . '
Down Payment: ' . $_POST['Down_Payment'] . '
Original Note Amount: ' . $_POST['Original_Note_Amount'] . '
Current Balance: ' . $_POST['Current_Balance'] . '
Payment Frequency: ' . $_POST['Payment_Frequency'] . '
Date of First Payment: ' . $_POST['Date_of_First_Payment'] . '
Next Payment Due: ' . $_POST['Next_Payment_Due'] . '
Principal and Interest Payment: ' . $_POST['Principal_and_Interest_Payment'] . '
Interest Rate: ' . $_POST['Interest_Rate'] . '
Lien Position: ' . $_POST['Lien_Position'] . '
If Wrap indicate amount you owe: ' . $_POST['If_Wrap_indicate_amount_you_owe'] . '
Balloon Date: ' . $_POST['Balloon_Date'] . '
Does note on business include real estate: ' . $_POST['Does_note_on_business_include_real_estate'] . '
Current Estimated Value of Property: ' . $_POST['Current_Estimated_Value_of_Property'] . '
Other Information: ' . $_POST['Other_Information'] . '
';
$from="From: " . $_POST['email'] . "\r\n";
#echo $message;
foreach ($recipient as $this_recipient) {
mail($this_recipient,$subject,$message,$from);
}
?>
Thank you for filling out this questionnaire!
A representative from Western Financial will contact you shortly to provide your free, no obligation quote.
If you have sold a business and carried back a note and would like to convert your periodic payments to CA$H, Western Financial can help.
For a free, no obligation analysis and quote on the cash value of your business note simply call us toll free at 1 800 538-0540 or complete the Business Note Free Quote Questionnaire and submit it to Western Financial.
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