Notice Of Conduit Mortgage Payment With Debtor'S Authorization
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1VTB FORM Y-2
09/10
UNITED STATES BANKRUPTCY COURT
DISTRICT OF VERMONT
_____________________________________
In re:
Chapter 13
Debtor(s).
Case # _______
_____________________________________
N
C
M
P
W
D
’
A
OTICE OF
ONDUIT
ORTGAGE
AYMENT
ITH
EBTOR
S
UTHORIZATION
M
C
R
I
C
13 T
*
FOR
ORTGAGE
REDITOR TO
ELEASE
NFORMATION TO THE
HAPTER
RUSTEE
The Debtor(s) in the above-captioned bankruptcy case do(es) hereby authorize any and all parties
who hold a mortgage on the Debtor(s)’s residential property to release information to the standing
Chapter 13 Trustee in this case, so the Trustee may distribute Conduit Mortgage Payments to them.
The information to be released includes, but is not limited to:
(i)
the loan origination date;
(ii)
the account number;
(iii)
the loan payment history;
(iv)
the amount of the regular monthly payment, as of the filing date of this case;
(v)
the annual interest rate and whether the interest rate is fixed or variable;
(vi)
the loan balance;
(vii)
the components of, and amounts in, the escrow account for this loan;
(viii) the amount of the contractual late charge and the date by which payment must be received
to avoid the imposition of a late charge;
(ix)
the mailing address to which payments should be sent; and
(x)
the name and contact information for the mortgage creditor’s representative to whom the
Trustee should direct any questions regarding payments on this loan.
This information will be used by the Trustee and the Trustee’s staff in the administration of this chapter
13 case and may be included, where pertinent, in motions filed in the Bankruptcy Court.
DATE: ___________________________
_________________________________________
Debtor's Signature
DATE: ___________________________
_________________________________________
Co-Debtor's Signature
_____
The Debtor shall send this completed form to the Trustee within seven (7) days of the chapter 13 case
being filed, at the following address:
Jan M. Sensenich, Chapter 13 Trustee, P.O. Box 1326, Norwich, VT 05055
and shall send a copy by that same date to the mortgage creditor. The Debtor need not file this form with
the Court.
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