Short Refinance

HOPE for Homeowners

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HOPE for Homeowners Form

--------------------Contact Info --------------------------------------

Homeowner(s) Name: *

Your Email: *

Best Phone Number to be reached: *

Alternate Phone #: *

Property Address (Address, City, State, Zip):

----------------------Hardship Issue-----------------------------------

Please describe the events and or circumstances which have caused you (or will cause you) to miss mortgage payments?:

When did this event and/or circumstance(s) begin?:

When will it end (or when did it end)?:

Describe the nature and amount of any increased expenses or income lost durnig this time.:

Are you currently employed?:
Yes
No

--IF YES, how long have you been with your current employer?:

--Are there any foreseeable changes in your employment?:

How long have you lived at the property?:

Have you considered selling the property to avoid foreclosure sale?
Yes
No

--IF YES, please describe why you would want to sell your home.:

--IF NO, please describe why you want to keep the property.:

What actions have you takes thus far to resolve your financial situation? (E.g. obtained additional employment, reduced optional monthly expenses):

Last Appraised Value (and Date if Applicable):

---------------------------1st Lien -------------------------------

1st Lender Name: (1st Lien) *

--Loan Number:

--Amount Owed: *

--Normal Monthly Payment: *

--Interest Rate: *

--Number of months behind: *

--Approx. amount behind ($): *

--Is this an ARM loan: *
Yes
No

--Did you fall behind after the rate adjustment?: *
Yes
No

--What caused the payment to become late?: *

---------------------------2nd Lien -------------------------------

2nd Lender Name (2nd Lien), if applicable:

--Amount Owed:

--Normal Monthly Payment:

--Interest Rate:

--Number of months behind:

--Approx. amount behind ($):

--Is this an ARM loan:
Yes
No

--Did you fall behind after the rate adjustment?:
Yes
No

--What caused the payment to become late?:

---------------------------3rd Lien -------------------------------

3rd Lender Name (3rd Lien), if applicable:

--Amount Owed:

--Normal Monthly Payment:

--Interest Rate:

--Number of months behind:

--Approx. amount behind ($):

--Is this an ARM loan:
Yes
No

--Did you fall behind after the rate adjustment?:
Yes
No

--What caused the payment to become late?: