Chase D19693 Rma 0913 Form PDF Details

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Question	Answer
Form Name	Chase D19693 Rma 0913 Form
Form Length	5 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	1 min 15 sec
Other names	chase form assistance, chase form print, chase loan modification forms download, chase request for mortgage assistance form

Form Preview Example

REQUEST FOR MORTGAGE ASSISTANCE FORM

Completing this form will help us understand your current situation.
We'll work with you to find a solution as quickly as possible.	Loan Number: _____________________________

Step 1: Tell us about you	For the purposes of this form, a Customer is someone who is obligated on the Note for the loan or
Step 1: Tell us about you	interested in assuming responsibility for the Note. If another person not on the Note has community
	property or similar rights per applicable state law, please provide their name: ______________________________

CUSTOMER

Customer’s name

Last four digits of Social	Date
Security number	of birth

Mobile or daytime number with area	Preferred contact method
Mobile or daytime number with area	Preferred contact method
code1	Text
	Voice
	Email
	Email

Email address

ADDITIONAL CUSTOMER

Customer’s name

		Last four digits of Social	Date
		Security number	of birth

		Mobile or daytime number with area	Preferred contact method
		Mobile or daytime number with area	Preferred contact method
		code1	Text
			Voice
			Email
			Email

		Email address
		Email address

1By providing your mobile phone number(s), you are giving Chase and companies working on its behalf permission to contact you at this number about all your Chase or J.P. Morgan accounts. Your consent permits the use of text messaging, artificial or prerecorded voice messages and automatic dialing technology for informational or account servicing purposes, but not for telemarketing or sales. Message and data rates may apply. You may contact us anytime to change these preferences.

Step 2: Help us understand your unique situation

HARDSHIP AFFIDAVIT

DESCRIBE YOUR HARDSHIP: __________________________________________________________________________________________

__________________________________________________________________________________________________________________________

_________________________________________________________________________________________________________________________

If your mortgage loan is insured or guaranteed by the Federal Housing Administration (FHA) or the Rural Housing Service (RHS), you are considered to be facing imminent default if your loan is up to date or less than 30 days past due and you have a hardship that will keep you from making your next mortgage loan paymentin the month it’s due.

Date situation began:

_______/_______/_______

I believe my situation is:

nTemporary n Long term

Check all boxes that explain your situation:

nUnemployment

n*For FHA ONLY: Unemployed customer not currently receiving benefits

Unemployment start date: _______________________

nExcessive obligations

nIncome reduction/underemployment

nPayment increase

nDivorce or legal separation; separation of customers unrelated by marriage, civil union or similar domestic partnership under applicable law

nDeath of a customer, or death of either the primary or

additional wage earner in the household or a dependent family member

nLong-term or permanent disability; serious illness of a customer, additional customer or a dependent family member

nDisaster (natural or man-made) adversely affecting the property or customer's place of employment

nDistant employment transfer

nBusiness failure

Please send us the documents that apply:

A copy of your benefits statement or letter detailing the amount, frequency and duration of your unemployment benefits.

Are you seeking new employment?	n	Yes	n No
Are you available for employment?	n	Yes	n No

For FHA, we need:

• An explanation of why the obligations are excessive, and

• Documents that support excessive obligation—including but not limited to monthly billing statements and home repair invoices

No hardship documentation is required as long as you have submitted documents that show your income. If you have an FHA loan, you may need to send more documents.

•Divorce decree or separation agreement signed by the court; or

•Current credit report showing divorce, separation or different address of non-occupying customer; or

•Recorded quitclaim deed showing that the non-occupying customer or additional customer has relinquished all rights to the property

•Death certificate; or

•Obituary or newspaper article reporting the death

Do not send medical records or any details of your illness or disability. Instead, please

send:

•Written statement from you or other documentation verifying disability or illness; or

•Proof of monthly insurance benefits or government assistance (with expiration date, if applicable)

•Insurance claim; or

•Proof of a FEMA grant or Small Business Administration loan; or

•Evidence that customer or employer property is in a federally-declared disaster area

•For active duty Servicemembers: Permanent Change of Station (PCS) orders or letter showing transfer

•For employment transfers/new employment:

•Copy of your signed offer letter, notice from your employer showing transfer to a new location (if applicable), or written explanation from your employer; and

•Documentation that reflects the amount of any relocation assistance provided

•Tax return from the previous year (including all schedules), and

•Proof of business failure supported by one of the following:

•Bankruptcy filing for the business; or

•Two months of recent bank statements for the business account showing that business activity has stopped; or

•Most recent signed and dated quarterly or year-to-date profit and loss statement

nOther (please explain) _______________________________________________________________________________________________________________________________

RMA

12/2019

Page 1

REQUEST FOR MORTGAGE ASSISTANCE FORM

Step 3: Help us determine your optionsLoan Number: _____________________________

I'm interested in:	n	All assistance options
I'm interested in:

n Only options that involve moving out of the property ADDITIONAL CONTRIBUTOR INFORMATION (Optional)

Does anyone not listed on the loan live in and contribute financially to the household? n Yes n No

Monthly amount they contribute to the household (including amount contributed to the mortgage): $ ___________________________

First and Last Name(s): __________________________________________________	Please indicate any living expenses for this person(s) in
	the Contributor column of the Monthly Living Expenses
Last four digits of SSN: __________________________________________________	section of this form (see next page).

For each additional contributor on the property, please complete an Authorization to Obtain Consumer Credit Report form, which you’ll

find in the Forms Center at chase.com/MortgageAssistance. Please also provide proof of the contributor's income.

MONTHLY HOUSEHOLD INCOME

Customer

Co-Customer

Contributor

WAGE:
Employer 1 name: _________________________________________ Start date: _____/_____/_______
If you work seasonally or in the education field, how many months per year are you
paid:________		$	$	$

WAGE:
Employer 2 name: _________________________________________ Start date: _____/_____/_______
If you work seasonally or in the education field, how many months per year are you
paid:________		$	$	$

Self-employment income:
(Includes 1099 income)		$	$	$
Percentage of business ownership: _______%		$	$	$
Percentage of business ownership: _______%

Benefits Income:
Social Security benefits, investments, pensions or other retirement benefits		$	$	$
Please specify: ________________________________________		$	$	$
Please specify: ________________________________________

Voluntary Income:
Child support/alimony/separation maintenance		$	$	$
You aren’t required to disclose child support, alimony or separation		$	$	$

maintenance income unless you want us to consider it as qualifying income.

Gross rents/boarder rents received (Primary recipient)		$	$	$

Unemployment Income	Start Date _______ End Date _________	$	$	$

Food stamps/welfare (Primary recipient)		$	$	$

Tips, commissions, bonuses		$	$	$

Other (please specify) ____________________________________		$	$	$

TOTAL MONTHLY INCOME

RMA 12/2019

Page 2

REQUEST FOR MORTGAGE ASSISTANCE FORM

Loan Number: _____________________________

ADDITIONAL REQUIRED INFORMATION

MONTHLY LIVING EXPENSES

Expense		Customer(s)	Contributor(s)

Food (required field)	$		$

Utilities (required field)	$		$

Automobile (required field)
(insurance, maintenance, gas)	$		$
n No automobile	$		$
n No automobile

Life insurance premium	$		$

Clothing	$		$


Cable, internet, phone	$		$

Medical	$		$

Tuition/school	$		$

Child care (daycare, babysitting)	$		$

Child support/alimony	$		$

Total monthly living expenses	$		$

HOUSEHOLD ASSETS

Please provide the most recent statement for each account listed

Do you have any existing asset accounts as listed below?

Yes

If Yes, please complete this section excluding Retirement

Funds.

	Checking account #1		$
	Checking account #1		$
	Bank name: ________________________________________________________

	Checking account #2		$
	Bank name: ________________________________________________________

	Savings/money market #1		$
	Bank name: ________________________________________________________

	Savings/money market #2		$
	Savings/money market #2
	Bank name: ________________________________________________________

	CDs		$
	CDs

	Stocks/bonds		$

	Other cash on hand		$

	Other (please specify) _____________________________________________________________________		$

TOTAL ASSETS

RMA 12/2019

Page 3

REQUEST FOR MORTGAGE ASSISTANCE FORM

Step 4: Property Information

Loan Number: _____________________________

Property address: ____________________________________________________________________________

Number of people in household: ________________

The property is my:		Primary Residence
The property is:		Owner Occupied

	Number of vehicles: _______________
Second Home		Investment
Second Home		Investment
Renter Occupied		Vacant

If any customer or occupant of the property is a military Servicemember who is currently on Active Duty or has been on Active Duty within the last 12 months, or is a dependent of a Servicemember, please call Chase Military Services at 1-877-469-0110.

LIENS, MORTGAGES OR JUDGMENTS (if applicable)

Please list any other mortgages or liens associated with this property. If you have more than one loan with us, we'll need you to complete a Request for Mortgage Assistance form for each account you’d like us to review for assistance.


Servicer: ___________________________________________________________________________________		Account #: __________________________________________________
Servicer: ___________________________________________________________________________________		Account #: __________________________________________________
Servicer: ____________________________________________________________________________________		Account #: __________________________________________________

Condominium or HOA fees? n Yes n No	If yes, how much each month? $_____________		Are payments up to date? n Yes n No

If you own other properties, please fill out the following section.

OTHER PROPERTIES OWNED

Customers with more than two additional properties, please download the Schedule of Real Estate Owned form from the Forms

Center at chase.com/MortgageAssistance. Please include the completed form with this application.

Property address: ______________________________________________________________________________________ Monthly rents received: $ ______________________

1st mortgage servicer name: ______________________________________________________________________________________________________________________________

Loan #: ________________________________________________________________________ Monthly principal and interest payment: $ ______________________________

2nd mortgage servicername: ____________________________________________________________________________________________________________________________

Loan #: _______________________________________________________________________ Monthly principal and interest payment: $ ________________________________

Escrow payment (taxes, insurance, PMI): $_______________ Property is: n Vacant n Second/seasonal home n Owner-occupied n Rented

Monthly condominium or HOA fees: $_____________________ Comments: __________________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________

Property address: ___________________________________________________________________________________ Monthly rents received: $ ______________________

1st mortgage servicer name: ___________________________________________________________________________________________________________________________

Loan #: ________________________________________________________________________ Monthly principal and interest payment: $ _______________________________

2nd mortgage servicer name: ___________________________________________________________________________________________________________________________


Loan #:	_____________________________________________________________________ Monthly principal and interest payment: $ ______________________________
Escrow payment (taxes, insurance, PMI): $______________ Property is: n Vacant		n Second/seasonal home n Owner-occupied	n Rented
Monthly	condominium or HOA fees: $_____________________ Comments: ___________________________________________________________________________

________________________________________________________________________________________________________________________________________________________________

Third-Party Authorization:

If you want, you can authorize someone to work with us on your behalf. This is optional.

I/We hereby authorize JPMorgan Chase Bank, N.A., to release, furnish and provide information related to my/our account to:

Name of third party _______________________________________________________________________ Phone number (________)_____________________________________

Address of third party_______________________________________________________________________________________________________________________________________

RMA 12/2019

Page 4

REQUEST FOR MORTGAGE ASSISTANCE FORM

Step 5: Please read carefully and sign

Loan Number: _____________________________

ACKNOWLEDGMENT AND AGREEMENT

In making this request for consideration, I certify under penalty of

perjury that I understand and agree that:

1.The servicer of my mortgage loan may pull a current credit report for all customers obligated on the Note for the loan.

2.If my liability for the mortgage debt was discharged in a Chapter 7 bankruptcy proceeding after I signed the mortgage documents, or if I am entitled to the protections of any automatic stay in bankruptcy, the servicer is providing information about the mortgage assistance program at my request and for informational purposes, and not as an attempt to impose personal liability for the mortgage debt.

3.If I am eligible for a Trial Period Plan, Repayment Plan or Forbearance Plan, and I accept and agree to all the terms of such a plan, I also agree that the terms of this Acknowledgment and Agreement are incorporated into that plan.

4.If I'm eligible for an assistance option that requires an escrow account to pay taxes and/or insurance and my mortgage loan doesn’t have one, the servicer may establish one. If my loan previously had an escrow account and the servicer agreed to remove this requirement, this agreement has been revoked.

5.All the information in this document is true, and the hardships listed in Step 2 explain why I’m requesting mortgage assistance.

6.The servicer, owner, or guarantor of my mortgage or their agents may investigate the accuracy of my statements and I may need to provide additional documentation.

7.The servicer may directly obtain copies of account statements, including, but not limited to, checking and savings accounts, certificates of deposit (even if held for an extended period of time), mutual funds, money market funds, stocks or bonds, on accounts that are held by the servicer, its subsidiaries and affiliates for the review of my request for mortgage assistance.

8.If I have intentionally defaulted on my existing mortgage or engaged in fraud, or if any of the information I’ve provided is false, I may be ineligible for assistance under applicable investor/insurer programs or guidelines. This includes ineligibility now and for any future benefits and incentives that would otherwise have been available. I also understand that the servicer may recover any benefits or incentives I’ve previously received.

9.The property securing the mortgage I’m requesting assistance for can be lived in and hasn’t been or isn’t at risk of being condemned.

10.The servicer will use the information I provide to determine my eligibility for mortgage assistance, but isn’t obligated to offer me assistance based solely on the statements in this or any other document I send as part of this request.

11.The servicer will collect and record personal information, including my name, address, phone number, Social Security number, credit score, income, payment history and information about account balances and activity. I understand and consent to the disclosure of my personal information and the terms of any mortgage assistance option I receive by the servicer to (a) any investor, insurer, guarantor or servicer of my mortgage loan(s);(b) companies that perform support services in conjunction with any other mortgage relief program; and (c) any HUD-certified housing counselor.

12. The Servicer, Lender, and Other Loan Participants can obtain, use and share tax return information for purposes of (i) providing an offer; (ii) originating, maintaining, managing, monitoring, servicing, selling, insuring, and securitizing a loan; (iii) marketing; or (iv) as otherwise permitted by applicable laws, including state and federal privacy and data security laws. References to “Servicer” and “Lender” in the first sentence shall be deemed to include both parties’ vendors, affiliates, agents, service providers, and any of the aforementioned parties’ successors and assigns. The reference to “Other Loan Participants” in the first sentence shall also include any actual or potential owners of the loan, or acquirers of any beneficial or other interest in the loan, any mortgage insurer, guarantor, any servicers or service providers for these parties and any of the aforementioned parties’ successors and assigns.

13. If I, or someone on my behalf, have submitted a Fair Debt Collection Practices Act cease and desist notice to my Servicer, I withdraw that notice and understand that the servicer must contact me throughout the mortgage assistance process.

14. I consent to being contacted about this request for mortgage assistance at any email address I have provided.

By signing this document, I/we certify that all the information is truthful.

I/We understand that knowingly submitting false information may constitute fraud.

Customer Signature _______________________________________________________________________ Date _______/_______/__________

mm dd yyyy

Additional Customer Signature ____________________________________________________________ Date _______/_______/_________

mm dd yyyy

Step 6: Here’s how to send your documents

When we receive this form and all required documents, we’ll assign a team of dedicated specialists

to your loan who will call you within five business days to talk about your next steps.

Here’s how you can send your information.	Overnight Mail:	Regular Mail:	Fax:
After you have submitted your documentation,	Chase	Chase	1-866-282-5682
please call us at 1-877-496-3138 to let us know.	720 S. Colorado Blvd., STE 210	PO Box 469030
	Glendale, CO 80246-1904	Glendale, CO 80246-9030	Online: chase.com

If you have questions about this document or the assistance process, please call Chase. If you have questions about government programs that we cannot answer or you need further counseling, call the Homeowner’s HOPE™ Hotline at 1-888-995-HOPE (4673). The hotline can answer questions about the program and offers free HUD-certified counseling services in English and Spanish.

For a list of HUD-approved counseling agencies that can provide foreclosure prevention information, contact the U.S. Department of Housing and Urban Development (HUD) at 1-800-569-4287 or hud.gov/counseling.

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For additional forms, please visit chase.com/MortgageAssistance

Si tiene alguna pregunta sobre asistencia hipotecaria, por favor llame al 1-877-496-3138.

RMA

12/2019

Page 5

How to Edit Chase D19693 Rma 0913 Form Online for Free

The PDF editor that you may apply was designed by our main web programmers. It is possible to get the chase request mortgage file immediately and conveniently applying our software. Simply keep up with this instruction to get started.

Step 1: The initial step will be to click the orange "Get Form Now" button.

Step 2: After you have entered the chase request mortgage edit page, you will notice all options you can take concerning your document at the top menu.

The particular sections will help make up the PDF form:

Note the demanded particulars in the area If your mortgage loan is insured, Date situation began, I believe my situation is n, Check all boxes that explain your, Please send us the documents that, Unemployment, n For FHA ONLY Unemployed customer, receiving benefits, Unemployment start date, n Excessive obligations, n Income reductionunderemployment, n Payment increase, n Divorce or legal separation, A copy of your benefits statement, and Are you seeking new employment Are.

2019 chase form If your mortgage loan is insured, Date situation began, I believe my situation is n, Check all boxes that explain your, Please send us the documents that, Unemployment, n For FHA ONLY Unemployed customer, receiving benefits, Unemployment start date, n Excessive obligations, n Income reductionunderemployment, n Payment increase, n Divorce or legal separation, A copy of your benefits statement, and Are you seeking new employment Are fields to complete

Write down the essential data in n Distant employment transfer, n Business failure, For active duty Servicemembers, showing transfer, For employment transfersnew, Copy of your signed offer letter, new location if applicable or, Tax return from the previous year, Bankruptcy filing for the, showing that business activity has, Most recent signed and dated, loss statement, n Other please explain, RMA, and Page section.

The Step Help us determine your, Im interested in, n All assistance options, Loan Number, n Only options that involve moving, Does anyone not listed on the loan, n No, ADDITIONAL CONTRIBUTOR INFORMATION, First and Last Names, Last four digits of SSN, Please indicate any living, For each additional contributor on, MONTHLY HOUSEHOLD INCOME, Customer, and CoCustomer area is the place to add the rights and responsibilities of all sides.

Finalize by reviewing the following fields and filling them in accordingly: WAGE Employer name Start date, Selfemployment income Includes, Benefits Income Social Security, Voluntary Income Child, You arent required to disclose, Gross rentsboarder rents received, Unemployment Income, Start Date, End Date, and Food stampswelfare Primary.

Step 3: When you click the Done button, your finalized file can be exported to each of your gadgets or to email given by you.

Step 4: You can create copies of the file toremain away from any type of potential challenges. Don't worry, we cannot distribute or track your data.

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