Form 710 Fannie Mae – Fill Out and Use This PDF

UNIFORM BORROWER ASSISTANCE FORM

If you are experiencing a temporary or long-term hardship and need help, you must complete and submit this form along with other required documentation to be considered for available solutions. On this page, you must disclose information about (1) you and your intentions to either keep or transition out of your home; (2) the property’s status; (3) bankruptcy; and (4) your credit counseling agency.

On Page 2, you must disclose information about all of your income, expenses and assets. Page 2 also lists the required income documentation that you must submit in support of your request for assistance. Then on Page 3, you must complete the Hardship Affidavit in which you disclose the nature of your hardship. The Hardship Affidavit informs you of the required documentation that you must submit in support of your hardship claim.

NOTICE: In addition, when you sign and date this form, you will make important certifications, representations and agreements, including certifying that all of the information in this Borrower Assistance Form is accurate and truthful and any identified hardship has contributed to your submission of this request for mortgage relief.

REMINDER: The Borrower Response Package you need to return consists of: (1) this completed, signed and dated Borrower Assistance Form; (2) completed and signed IRS Form 4506T-EZ (4506T for self-employed borrowers or borrowers with rental income); (3) required income documentation; and (4) required hardship documentation.

Loan Number ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ(usually found on your monthly mortgage statement)

Servicer’s Name ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ

I want to:

Keep the Property

Vacate the Property

Sell the Property

Undecided

The property is currently:

My Primary Residence

A Second Home

An Investment Property

The property is currently:

Owner Occupied

Renter Occupied

Vacant

BORROWER

CO-BORROWER

BORROWER’S NAME

CO-BORROWER’S NAME

SOCIAL SECURITY NUMBER

DATE OF BIRTH

SOCIAL SECURITY NUMBER

DATE OF BIRTH

HOME PHONE NUMBER WITH AREA CODE

HOME PHONE NUMBER WITH AREA CODE

CELL OR WORK NUMBER WITH AREA CODE

CELL OR WORK NUMBER WITH AREA CODE

MAILING ADDRESS

PROPERTY ADDRESS (IF SAME AS MAILING ADDRESS, JUST WRITE SAME)

EMAIL ADDRESS

Is the property listed for sale?

Yes

No

Have you contacted a credit counseling agency for help?

If yes, what was the listing date? ___________

Yes

No

If property has been listed for sale, have you received an offer on the

If yes, please complete the counselor contact information below:

property?

___________

Yes

No

Counselor’s Name: ___________________________________

Date of offer:

Amount of Offer: $ _______________

Agency’s Name:

___________________________________

Agent’s Name:

____________________________________________

Counselor’s Phone Number: ____________________________

Agent’s Phone Number:

Counselor’s Email Address:

____________________________

For Sale by Owner?

Yes

No

Do you have condominium or homeowner association (HOA) fees?

Yes

No

Total monthly amount: $

Name and address that fees are paid to:

Is any Borrower an active duty service member?		Yes	No
Has any Borrower been deployed away from his/her primary residence or received a Permanent Change of Station order?		Yes	No
Is any Borrower the surviving spouse of a deceased service member who was on active duty at the time of death?		Yes	No
Fannie Mae/Freddie Mac Form 710	Page 1 of 4		June	4

UNIFORM BORROWER ASSISTANCE FORM

Monthly Household Income			Monthly Household Expenses and Debt		Household Assets (associated with the
			Payments		property and/or borrower(s)excluding
					retirement funds)
Gross wages	$		First Mortgage Payment	$	Checking Account(s)	$
Overtime	$		Second Mortgage Payment	$	Checking Account(s)	$
Child Support / Alimony*	$		Homeowner’s Insurance	$	Savings / Money Market	$
Non-taxable social security/SSDI	$		Property Taxes	$	CDs	$
Taxable SS benefits or other monthly	$		Credit Cards / Installment Loan(s) (total	$	Stocks / Bonds	$
income from annuities or retirement			minimum payment per month)
plans
Tips, commissions, bonus and self-	$		Alimony, child support payments	$	Other Cash on Hand	$
employed income
Rents Received	$		Car Lease Payments	$	Other Real Estate (estimated value)	$
Unemployment Income	$		HOA/Condo Fees/Property Maintenance $		Other	$
Food Stamps/Welfare	$		Mortgage Payments on other properties $			$
Other	$		Other	$		$
Total (Gross income)	$		Total Household Expenses and Debt	$	Total Assets	$

Payments

Any other liens (mortgage liens, mechanics liens, tax liens, etc.)

Required Income Documentation

Do you have any additional sources of income? Provide for each borrower as applicable:

“Other Earned Income” such as bonuses, commissions, housing allowance, tips, or overtime:

Reliable third-party documentation describing the amount and nature of the income (e.g., paystub, employment contract or printouts documenting tip income).

Social Security, disability or death benefits, pension, public assistance, or adoption assistance:

Documentation showing the amount and frequency of the benefits, such as letters, exhibits, disability policy or benefits statement from the provider, and

Documentation showing the receipt of payment, such as copies of the two most recent bank statements showing deposit amounts.

Rental income:

Copy of the most recent filed federal tax return with all schedules, including Schedule E—Supplement Income and Loss. Rental income for qualifying purposes will be 75% of the gross rent you reported reduced by the monthly debt service on the property, if applicable; or

If rental income is not reported on Schedule E – Supplemental Income and Loss, provide a copy of the current lease agreement with either bank statements or cancelled rent checks demonstrating receipt of rent.

Investment income:

Copies of the two most recent investment statements or bank statements supporting receipt of this income.

Alimony, child support, or separation maintenance payments as qualifying income:*

Copy of divorce decree, separation agreement, or other written legal agreement filed with a court, or court decree that states the amount of the alimony, child support, or separation maintenance payments and the period of time over which the payments will be received, and Copies of your two most recent bank statements or other third-party documents showing receipt of payment.

*Notice: Alimony, child support, or separate maintenance income need not be revealed if you do not choose to have it considered for repaying this loan.

Fannie Mae/Freddie Mac Form 710

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Borrower/Co-Borrower Acknowledgement and Agreement

I certify, acknowledge, and agree to the following:

1.All of the information in this Borrower Assistance Form is truthful and the hardship that I have identified contributed to my need for mortgage relief.

2.The accuracy of my statements may be reviewed by the Servicer, owner or guarantor of my mortgage, their agent(s), or an authorized third party*, and I may be required to provide additional supporting documentation. I will provide all requested documents and will respond timely to all Servicer, or authorized third party*, communications.

3.Knowingly submitting false information may violate Federal and other applicable law.

4.If I have intentionally defaulted on my existing mortgage, engaged in fraud or misrepresented any fact(s) in connection with this request for mortgage relief or if I do not provide all required documentation, the Servicer may cancel any mortgage relief granted and may pursue foreclosure on my home and/or pursue any available legal remedies.

5.The Servicer is not obligated to offer me assistance based solely on the representations in this document or other documentation submitted in connection with my request.

6.I may be eligible for a trial period plan, repayment plan, or forbearance plan. If I am eligible for one of these plans, I agree that:

a.All the terms of this Acknowledgment and Agreement are incorporated into such plan by reference as if set forth in such plan in full.

b.My first timely payment under the plan will serve as acceptance of the terms set forth in the notice of the plan sent by the Servicer.

c.The Servicer’s acceptance of any payments under the plan will not be a waiver of any acceleration of my loan or foreclosure action that has occurred and will not cure my default unless such payments are sufficient to completely cure my entire default under my loan.

d.Payments due under a trial period plan for a modification will contain escrow amounts. If I was not previously required to pay escrow amounts, and my trial period plan contains escrow amounts, I agree to the establishment of an escrow account and agree that any prior waiver is revoked. Payments due under a repayment plan or forbearance plan may or may not contain escrow amounts. If I was not previously required to pay escrow amounts and my repayment plan or forbearance plan contains escrow amounts, I agree to the establishment of an escrow account and agree that any prior escrow waiver is revoked.

7.A condemnation notice has not been issued for the property.

8.The Servicer or authorized third party* will obtain a current credit report on all borrowers obligated on the Note.

9.The Servicer or authorized third party* will collect and record personal information that I submit in this Borrower Response Package and during the evaluation process. This personal information may include, but is not limited to: (a) my name, address, telephone number, (b) my social security number, (c) my credit score, (d) my income, and (e) my payment history and information about my account balances and activity. I understand and consent to the Servicer or authorized third party*, as well as any investor or guarantor (such as Fannie Mae or Freddie Mac), disclosing my personal information and the terms of any relief or foreclosure alternative that I receive to the following:

a.Any investor, insurer, guarantor, or servicer that owns, insures, guarantees, or services my first lien or subordinate lien (if applicable) mortgage loan(s) or any companies that perform support services to them; and

b.The U.S. Department of Treasury, Fannie Mae and Freddie Mac, in conjunction with their responsibilities under the Making Home Affordable program, or any companies that perform support services to them.

10.I consent to being contacted concerning this request for mortgage assistance at any telephone number, including mobile telephone number, or email address I have provided to the Lender/Servicer/ or authorized

third party*. By checking this box, I also consent to being contacted by text messaging.
_________________________________	__________	___________________________	__________
Borrower Signature	Date	Co-Borrower Signature	Date

*An authorized third party may include, but is not limited to, a counseling agency, Housing Finance Agency (HFA) or other similar entity that is assisting me in obtaining a foreclosure prevention alternative.

Fannie Mae/Freddie Mac Form 710

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