Hardship Affidavit Form printable pdf download

Hardship Affidavit Form

Borrower/Co-Borrower Information

Loan Number______________________________

Name(s)

_____________________________________________________

Phone Numbers

_____________________________________________________

Property Information

Property Street Address

_____________________________________________________

Property City and State

_____________________________________________________

Mailing Street Address

_____________________________________________________

Mailing City and State

_____________________________________________________

In order to be evaluated for a foreclosure prevention alternative offered by West Virginia Housing Development Fund,

I am submitting this form and indicating by my checkmarks the one or more events that contribute to my difficulty

making payments on my mortgage loan.

I am having difficulty making my monthly payments because of financial difficulties created by:

(check all that apply)

_____

My household income has been reduced. For example: unemployment, underemployment, reduced

pay or hours, decline in business earning, death, disability or divorce of borrower or co-borrower.

_____

My monthly debt payments are excessive, and I am overextended with my creditors. Debt includes

Credit cards, home equity or other debt.

_____

My expenses have increased. For example: monthly mortgage payment reset, high medical or health

care costs, uninsured losses, increased utilities or property taxes.

_____

My cash reserves, including all liquid assets, are insufficient to maintain my current mortgage payment

and cover basic living expenses at the same time.

_____

Other: ______________________________________________________________________________

_____________________________________________________________________________________

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Hardship Affidavit Form