Mac Form 710 - Uniform Borrower Assistance Form Page 10
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17Uniform Borrower Assistance Form Expenses Breakdown
**Please include all items you are currently responsible for, even if you are not current on those payments**
Financial Information Statement
Borrower
Co-Borrower
How many people are in the
household? (including yourself)
INCOME
Monthly income from
Employment
Frequency of Pay Period
Monthly Government Benefits
and Insurance Income
Monthly Unemployment Income
Monthly Rental Income
Monthly Alimony Income
Monthly Child Support Income
Other Monthly Income
Please describe other below:
Total Monthly Income
-
-
=
=
HOME EXPENSES - PRIMARY
RESIDENCE
ST
1
Lien Monthly Payment
nd
2
Lien Monthly Payment
Monthly Rent Payment
Monthly HOA Dues
Monthly Property Taxes (if not
included in mortgage payment)
Monthly Home Repairs
Monthly Cable TV
Monthly Electricity
Monthly Natural Gas
Monthly Phone/Internet
Monthly Sewer/Water
Other Monthly Home Expenses
Please describe other below:
Total Monthly Home Expenses
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