Foreclosure Prevention Counseling Forms Page 3
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4Form 2: Information Request for Loan Servicer from Housing
Counselor
Borrower(s) _____________________________________________
Loan #: ________________________________________________
Address ________________________________________________
Pursuant to the attached authorization by the borrower(s), please supply the following
information about the above referenced account. The information will be used to help the borrower
propose a loss mitigation plan, if possible.
Mortgage Investor: ____________________________________________
Investor Loan #: ______________________________________________
Mortgage Insurance Company: ____________________________________________________
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Loan Payment Info:
Current Interest Rate: ____________%
Monthly Principal & Interest Payment: _______________
Monthly Escrow payment: __________________
Total Monthly Mortgage Payment: ___________________
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Amount of Arrears:
Due For (Earliest unpaid installment): ____________________________
Late Charges Due: ___________________________________________
Foreclosure Fees & Costs Due: _________________________________
Other Unpaid Charges: ________________________________________
Balance in Suspense Account: ______________________________
TOTAL ARREARS (as of _____________)
$______________
Total Balance Due on Loan:
Unpaid Principal Balance: _____________________
Past Due Interest: ____________________________
Unpaid Escrow: ____________________________
TOTAL AMOUNT DUE ON LOAN (PAY-OFF) (as of ______________ ) $ _____________
Per Diem Interest:
Date of Most Recent BPO / Appraisal:________________________
Value:__________________________________________________
Other Comments: ________________________________________
FORECLOSURE STATUS: __________________________________________________________
SALE DATE (IF SCHEDULED): _____________________________________________________
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