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Making Home Affordable Program Request for …

Making home Affordable Program Request for mortgage assistance (RMA). Request For mortgage assistance (RMA) page 1 COMPLETE ALL PAGES OF THIS FORM. Requesting mortgage assistance for mortgage loan number: I/We want to: Keep the property Sell the property The property is my/our: Primary residence Second home Investment property The property is: Owner occupied Renter occupied Vacant Borrower information Borrower Co-borrower Borrower's name Co-borrower's name Social Security number Date of birth Social Security number Date of birth home phone number home phone number ( ) ( ). Cell phone number Cell phone number ( ) ( ). Work phone number Work phone number ( ) ( ). Email address Email address Mailing address Mailing address (if different than borrower's). Have you contacted a credit-counseling agency for help? Yes No If yes, complete counselor contact information below.

Request for Mortgage Assistance Form RFDocType 50431 Page 1 of 10 78381MU 05/12 BARCODE Making Home Affordable Program Request for Mortgage Assistance (RMA)

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