Name

Email

Phone

Property Address

Gross Monthly Income

Total Monthly Expenses

What type of property do you own?
Single family home on residential lotSingle family home on farmlandFarmland onlyCondominiumApartment complexCommercial propertyTownhomeOther

What is the approximate square footage?

Are there multiple structures on the property? (e.g. barns, guest house, etc.) If so, please describe

Does your property belong to a homeowner's association, condo association or other organization?
YesNo

If yes, are you current on your dues?
YesNo

If no, how much do you owe in dues?

When did you obtain your current home loan?

What is the approximate balance on your home loan?

Are you current on your home loan?
YesNo

If no, how many months behind are you? How much would it cost to get current on your loan?

What is your current interest rate?

Who is the current lender on your loan?

Do you have more than one loan on this property? If yes, please explain.

Are there any liens or judgments against this property? If yes, please explain.

Is your home currently in foreclosure status? If yes, please discuss the details along with any relevant deadlines.

Is there any additional information that you feel is important to mention?

Please upload any relevant or supporting documents