Fillable Loan Modification Checklist Template

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Loan Modification Checklist

Submission Date

–

OCKET

Borrower and Co-Borrower Information

Borrower’s Name

Co-Borrower’s Name

Subject Property Address

Street Address

City

State

Zip Code

Lender

Loan Modification Documents - Write the loan number on the top of every page.

Hardship letter - signed and dated.

Request for Mortgage Assistance Form (fill out carefully) - signed and dated. (to access this form, go to

, select “Get Started: from the menu, then select “Request a Modification.”)

Dodd Frank Certification signed and dated (to access, go to , select “Get Started:

from the menu, then select “Request a Modification.” The Dodd-Frank Certification appears on page 7 of the

Mortgage Assistance Form.)

Paystubs for each wage earner totaling one current month of income.

List of recurring monthly expenses, signed and dated.

Copies of all W-2’s, for the last 2 years.

Federal Tax Returns for the last 2 years (include all pages and schedules) - signed and dated.

Provide copies of all bank statements and all accounts, for the last 2 months. Make sure to include all pages, even

if they are blank. (Remember to write the loan number on every page.)

Tax Form 4506-T - signed and dated (to access this form, go to , select “Get

Started: from the menu, then select “Request a Modification.” The Tax form is the second option.)

Provide a copy of your most recent Gas and Electric bill; verifying that the home is the primary address.

If you or anyone in your household receives social security, pension income, or disability of any kind, provide a

copy of the most recent award letter(s), and circle the direct deposit of these funds into your bank account on your

statements.

If you receive alimony and/or child support, please provide a copy of your divorce/separation decree and a copy of

the court order with the amount of your child support and/or alimony. If the funds are directly deposited into a

bank account, please circle these deposits on the statements.

Rental income must be documented with a rental agreement, signed and dated. Rental income must be circled on

bank statements appearing as deposits on a monthly basis (cash rental receipts are not acceptable).

If someone else in your household, who is not on the mortgage, contributes financially to the household please

provide a letter stating how much this person contributes to the household each month. Each of you must sign

and date the letter (this may include your spouse).

Self-Employed Borrowers - In addition to items listed above, please submit the following:

Year to date Profit and Loss statement.

Provide copies of all bank statements and business accounts for the last 4 months. Make sure to include all pages,

even if they are blank.

Published 10/2012, CN 11655, English

Loan Modification Checklist Template - Mha

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