Ongoing Mortgage Paymet Form - Chapter 13 Bankruptcy Trustee, District Of Nevada

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KATHLEEN A. LEAVITT
Chapter 13 Bankruptcy Trustee, District of Nevada
201 Las Vegas Blvd. South • Suite 200 • Las Vegas, NV 89101
Phone (702) 853-0700 • Fax (702) 853-0713
In Re: __________________________________
Case Number: ________________________
Property Address: ______________________________________________________________
PLEASE COMPLETE THE FOLLOWING INFORMATION FOR ONGOING MORTGAGE PAYMENTS
CONNECTED WITH THE ABOVE ADDRESS, ANDFAX THIS INFORMATION TO THE ABOVE NUMBER
WITHIN 3 BUSINESS DAYS TO INSURE PROMPT PAYMENT OF ON-GOING MORTGAGE PAYMENTS.
Correct Creditor Name and Payment Address for on-going mortgage payments while in bankruptcy:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Creditor’s Phone Number: __________________________________
Contact Person for Account: ________________________________
Attorney name: (if any) __________________________________________________________
Attorney address:
__________________________________________________________
Attorney phone number: _________________________________________________________
Current Mortgage Account Number: ________________________________________________
New Mortgage Account Number due to bankruptcy (if any): _____________________________
Exact Amount of the Current Installment Payment From date of filing:
Principal & Interest:
$_______________
Late Fees: $________
Taxes
$_______________
Grace Period of: _____Days
Insurance:
$_______________
Mortgage Insurance Premium:
$_______________ Estimated Ending Date ___________
Other 1.__________
$_______________
2. __________
Grand Total:
$_______________
Date Current Payment is Due: _________________
Escrow account reviewed: Annually _______ Semi-annually _______ Next Scheduled Review _________
Type of Loan: Conventional _______ Adjustable Rate Mortgage ________ Balloon _______
If Adjustable: How often is it adjusted _________
When is the next scheduled adjustment date __________
Current Interest Rate: ___________
When is the Balloon Payment due ___________________
Is the loan due in full and payable in less than 5 years? _______
If yes, date due: ______________
Print name: ___________________________
Title: ________________________________
Company: ____________________________
____________________________________
_______________________
Signature:
Date:
TO BE FILLED OUT BY CREDITOR
Rev 9/16/10

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