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Request for Mortgage Assistance Form

Request FOR Mortgage Assistance FORMC ompleting this form will help us understand your current ll work with you to find a solution as quickly as possible. Loan Number: _____For the purposes of this form, a Customer is someone who is obligated on the Note for the loan orinterested in assuming responsibility for the Note. If another person not on the Note has communityproperty or similar rights per applicable state law, please provide their name: _____CUSTOMERHARDSHIP AFFIDAVITDESCRIBE YOUR HARDSHIP: _____ Date situation began:_____/_____/_____I believe my situation is:TemporaryLong termCheck all boxes that explain your situation:Please send us the documents that apply:Step 1: Tell us about youUnemployment start date: _____ Are you seeking new employment?

Insurance claim; or •Proof of a FEMA grant or Small Business Administration loan; or • Evidence that customer or employer property is in a federally-declared disaster area Distant employment transfer • For active duty Servicemembers: Permanent Change of Station (PCS) orders or letter showing transfer •For employment transfers/new ...

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we will not have any liability if we decline to release your account information because we are unable to authenticate the true identity of the authorized requestor seeking account information. This authorization will remain valid until revoked.

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