Fillable Request For Mortgage Assistance (Rma) Form printable pdf download

Making Home Affordable Program

Request For Mortgage Assistance (RMA)

REQUEST FOR MORTGAGE ASSISTANCE (RMA) page 1

COMPLETE ALL FOUR PAGES OF THIS FORM

Loan I.D. Number____________________________________________

Servicer ____________________________________________________

BORROWER

CO-BORROWER

Borrower’s name

Co-borrower’s name

Social Security Number

Home phone number with area code

Cell or work number with area code

I want to:

Keep the Property

Sell the Property

The property is my:

Primary Residence

Second Home

Investment Property

The property is:

Owner Occupied

Renter Occupied for Less than 12 Months

Vacant for Less than 12 Months

Mailing address

Property address (if same as mailing address, just write same)

E-mail address

Is the property listed for sale?

Yes

Have you contacted a credit-counseling agency for help

Yes

Have you received an offer on the property?

Yes

If yes, please complete the following:

Date of offer _________ Amount of offer $_____________________

Counselor’s Name: _________________________________________

Agent’s Name: ___________________________________________

Agency Name: ____________________________________________

Agent’s Phone Number: ____________________________________

Counselor’s Phone Number: __________________________________

For Sale by Owner?

Yes

Counselor’s E-mail: ________________________________________

Who pays the real estate tax bill on your property?

Who pays the hazard insurance premium for your property?

I do

Lender does

Paid by condo or HOA

I do

Lender does

Paid by Condo or HOA

Are the taxes current?

Yes

Is the policy current?

Yes

Condominium or HOA Fees

Yes

$ __________________

Name of Insurance Co.: ______________________________________

Paid to: _________________________________________________

Insurance Co. Tel #: _________________________________________

Have you filed for bankruptcy?

Yes

If yes:

Chapter 7

Chapter 13

Filing Date:_________________________

Has your bankruptcy been discharged?

Yes

Bankruptcy case number _________________________________

Additional Liens/Mortgages or Judgments on this property:

Lien Holder’s Name/Servicer

Balance

Loan Number

Contact Number

HARDSHIP AFFIDAVIT

I (We) am/are requesting review under the Making Home Affordable Program.

I am having difficulty making my monthly payment because of financial difficulties created by (check all that apply):

My household income has been reduced. For example: reduced pay

My monthly debt payments are excessive and I am overextended with

or hours, decline in business earnings, death, disability or divorce of a

my creditors. Debt includes credit cards, home equity or other debt.

borrower or co-borrower.

My expenses have increased. For example: monthly mortgage payment

My cash reserves, including all liquid assets, are insuﬃcient to maintain

reset, high medical or health care costs, uninsured losses, increased

my current mortgage payment and cover basic living expenses at the

utilities or property taxes.

same time.

I am unemployed and (a) I am receiving/will receive unemployment

Other:

beneﬁts or (b) my unemployment beneﬁts ended less than 6 months ago.

Explanation (continue on a separate sheet of paper if necessary): __________________________________________________________________

______________________________________________________________________________________________________________________

page 1 of 4

Request For Mortgage Assistance (Rma) Form

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