Request Modification Form PDF Details

Understanding and completing the Request Modification Form under the Making Home Affordable Program can be a crucial step for homeowners facing financial hardships. This comprehensive document is designed with three major sections that need to be filled out meticulously by those seeking to alter the terms of their mortgage in order to make their home more affordable. From the outset, it asks for detailed information about the borrower and co-borrower, if applicable, such as their names, social security numbers, contact information, and details about the property in question, including its occupancy status and whether it's listed for sale. More than just a formality, this process requires homeowners to disclose their intent regarding the property - to keep it or sell it, and delve into the nature of their hardship through an affidavit, explaining how financial difficulties have hampered their ability to keep up with mortgage payments. The underlying reasons could range from unemployment to increased expenses or significant life events. The form also necessitates a thorough account of the household income and expenses, scrutinizing the financial viability of the applicant(s). Additionally, it touches on legal aspects, such as bankruptcy and other liens that might affect the property. The form is not just about gathering data; it includes critical acknowledgments about the accuracy of the provided information, with stern warnings about the legal repercussions of falsification. Signing this document thus signifies a pledge of truthfulness under the risk of penal action for any deception. This form encapsulation not only aids servicers and the U.S. Department of the Treasury in assessing eligibility for loan modification but also represents a vital step for homeowners striving to regain financial stability by potentially adjusting their mortgage terms.

QuestionAnswer
Form NameRequest Modification Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesrequest affidavit form, making program rma request, making home affordable modification form, home program request modification

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Making Home Afordable Program

Reor Modiication and Aidavit A

REQOR MODIFICATION AND AFFIDAA page 1

COMPLETE ALL THREE PATHIS FORM

Loan I.D. Number____________________________________

Servicer ____________________________________

BORROWER

Borrower’s name

CO-BORROWER

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

I want to:

Keep the Property

Sell the Property

 

 

 

 

 

The property is my:

Primary Residence

Second Home

Investment

 

 

 

 

The property is:

Owner Occupied

Renter Occupied

Vacant

 

 

 

 

Mailing address

Property address (if same as mailing address, just write same)

 

 

 

E-mail address

 

 

 

 

 

 

 

 

 

 

 

Is the property listed for sale?

Yes

No

 

 

 

Have you contacted a credit-counseling agency for help

Yes

No

Have you received an ofer on the property?

Yes

No

 

If yes, please complete the following:

 

 

Date of ofer _________ Amount of ofer $_____________________

Counselor’s Name: _________________________________________

Agent’s Name: ___________________________________________

Agency Name: ____________________________________________

Agent’s Phone Number: ____________________________________

Counselor’s Phone Number: __________________________________

For Sale by Owner?

Yes

No

 

 

 

 

Counselor’s E-mail: ________________________________________

 

 

 

 

 

 

Who pays the real estate tax bill on your property?

 

 

Who pays the hazard insurance premium for your property?

 

 

I do

Lender does

Paid by condo or HOA

 

 

I do

Lender does

 

Paid by Condo or HOA

 

 

Are the taxes current?

 

Yes

No

 

 

 

 

Is the policy current?

Yes

No

 

 

Condominium or HOA Fees

Yes

No $ __________________

Name of Insurance Co.: ______________________________________

Paid to: _________________________________________________

Insurance Co. Tel #: _________________________________________

 

 

 

 

 

 

 

 

 

Have you iled for bankruptcy?

Yes

No

If yes:

Chapter 7

Chapter 13

Filing Date:_________________________

 

 

Has your bankruptcy been discharged?

Yes

 

No

Bankruptcy case number _________________________________

 

 

Additional Liens/Mortgages or Judgments on this property:

Lien Holder’s Name/Servicer

Balance

Contact Number

Loan Number

HARDSHIP AFFIDAVIT

I Wee reeview under the Making Home Afordable program.

I am having diiculty making my monthly payment because of inancial diiculties created by

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

My monthly debt payments are excessive and I am overextended with

 

underemployment, reduced pay or hours, decline in business earnings,

my creditors. Debt includes credit cards, home equity or other debt.

 

death, disability or divorce of a borrower or co-borrower.

 

 

 

 

 

My expenses have increased. For example: monthly mortgage payment

My cash reserves, including all liquid assets, are insufficient to maintain

 

reset, high medical or health care costs, uninsured losses, increased

my current mortgage payment and cover basic living expenses at the

 

utilities or property taxes.

same time.

 

 

 

 

Other:

Explanation (continue on back of page 3 if necessary): __________________________________________________________________________

______________________________________________________________________________________________________________________

page 1 of 3

REQOR MODIFICATION AND AFFIDAA page

 

 

 

COMPLETE ALL THREE PATHIS FORM

 

 

 

 

 

 

 

 

 

 

 

 

 

INCOME/EXPENSES FOR HOUSEHOLD1

 

 

 

Number of People in Household:

 

 

 

 

 

 

 

 

 

 

Monthly Household Income

 

Monthly Household Expenses/Debt

 

Household Assets

 

Monthly Gross Wages

 

$

 

First Mortgage Payment

 

$

 

Checking Account(s)

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Overtime

 

$

 

Second Mortgage Payment

 

$

 

Checking Account(s)

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Child Support / Alimony /

 

$

 

Insurance

 

$

 

Savings/ Money Market

 

$

 

Separation2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Social Security/SSDI

 

$

 

Property Taxes

 

$

 

CDs

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

Other monthly income from

 

$

 

Credit Cards / Installment

 

$

 

Stocks / Bonds

 

$

 

pensions, annuities or

 

 

 

Loan(s) (total minimum

 

 

 

 

 

 

 

retirement plans

 

 

 

payment per month)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tips, commissions, bonus

 

$

 

Alimony, child support

 

$

 

Other Cash on Hand

 

$

 

and self-employed income

 

 

 

payments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Rents Received

 

$

 

Net Rental Expenses

 

$

 

Other Real Estate

 

$

 

 

 

 

 

 

 

(estimated value)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Unemployment Income

 

$

 

HOA/Condo Fees/Property

 

$

 

Other _____________

 

$

 

 

 

 

Maintenance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food Stamps/Welfare

 

$

 

Car Payments

 

$

 

Other _____________

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other (investment income,

 

$

 

Other ________________

 

$

 

Do not include the value of life insurance or

 

 

 

 

 

 

royalties, interest, dividends

 

 

 

_____________________

 

 

 

retirement plans when calculating assets (401k,

etc.)

 

 

 

 

 

 

 

pension funds, annuities, IRAs, Keogh plans, etc.)

 

 

 

 

 

 

 

 

 

 

 

 

Total (Gross Income)

 

$

 

Total Debt/Expenses

 

$

 

Total Assets

 

$

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INCOME MUST BE DOCUMENTED

 

 

 

 

1Include combined income and expenses from the borrower and co-borrower yf you include income and expenses from a hous

ehold

 

 

member who is not a borrower, please specify using the back of this form if necessary.

 

 

 

2You are not required to disclose Child Support, Alimony or Separation Maintenance income, unless you choose to have it considered by your servicer.

INFORMATION FOR GOVERNMENT MONITORING PURPOSES

The following information is requested by the federal government in order to monitor compliance with federal statutes that prohibit discrimination in housing. You are not required to furnish this information, but are encouraged to do so. The law provides that a lender or servicer may not discriminate either on the basis of this information, or on whether you choose to furnish it. If you furnish the information, please provide both ethnicity and race. For race, you may check more than one designation. If you do not furnish ethnicity, race, or sex, the lender or servicer is required to note the information on the basis of visual observation or surname if you have made this request for a loan modification in person. If you do not wish to furnish the information, please check the box below.

BORROWER

I do not wish to furnish this information

 

CO-BORROWER

I do not wish to furnish this information

 

 

 

 

 

 

Ethnicity:

Hispanic or Latino

 

Ethnicity:

Hispanic or Latino

 

Not Hispanic or Latino

 

 

Not Hispanic or Latino

 

 

 

 

 

 

Race:

American Indian or Alaska Native

 

Race:

American Indian or Alaska Native

 

Asian

 

 

 

 

Asian

 

Black or African American

 

 

Black or African American

 

Native Hawaiian or Other Pacific Islander

 

 

Native Hawaiian or Other Pacific Islander

 

White

 

 

 

 

White

 

 

 

 

 

 

Sex:

Female

 

Sex:

Female

 

Male

 

 

 

 

Male

 

 

 

 

 

 

 

 

 

To be completed by interviewer

 

 

Name/Address of Interviewer’s Employer

This request was taken by:

 

Interviewer’s Name ype

 

 

 

Face-to-face interview

 

 

 

 

 

 

Interviewer’s Signature

Date

 

Mail

 

 

 

 

 

 

 

 

 

Telephone

 

 

 

 

 

 

 

 

Interviewer’s Phone Number ea code

 

Internet

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

page

REQOR MODIFICATION AND AFFIDAA

COMPLETE ALL THREE PATHIS FORM

ACKNOWLEDGEMENT AND AGREEMENT

1.That all of the information in this document is truthful and the event(s) identified on page 1 is/are the reason that I need to request a modification of the terms of my mortgage loan, short sale or deed-in-lieu of foreclosure.

I understand that the Servicer, the U.S. Department of the Treasury, or their agents may investigate the accuracy of my statements and may require me to provide supporting documentation. I also understand that knowingly submitting false information may violate Federal law.

3.I understand the Servicer will pull a current credit report on all borrowers obligated on the Note.

4.I understand that if I have intentionally defaulted on my existing mortgage, engaged in fraud or misrepresented any fact(s) in connection with this document, the Servicer may cancel any Agreement under Making Home Affordable and may pursue foreclosure on my home.

5.That: my property is owner-occupied; I intend to reside in this property for the next twelve months; I have not received a condemnation notice; and there has been no change in the ownership of the Property since I signed the documents for the mortgage that I want to modify.

6.I am willing to provide all requested documents and to respond to all Servicer questions in a timely manner.

7.I understand that the Servicer will use the information in this document to evaluate my eligibility for a loan modification or short sale or deed-in-lieu of foreclosure, but the Servicer is not obligated to offer me assistance based solely on the statements in this document.

8.I am willing to commit to credit counseling if it is determined that my financial hardship is related to excessive debt.

9.I understand that the Servicer will collect and record personal information, including, but not limited to, my name, address, telephone number, social security number, credit score, income, payment history, government monitoring information, and information about account balances and activity. I understand and consent to the disclosure of my personal information and the terms of any Making Home Affordable Agreement by Servicer to (a) the U.S. Department of the Treasury, (b) Fannie Mae and Freddie Mac in connection with their responsibilities under the Homeowner Affordability and Stability Plan; (c) any investor, insurer, guarantor or servicer that owns, insures, guarantees or services my first lien or subordinate lien (if applicable) mortgage loan(s); (d) companies that perform support services in conjunction with Making Home Affordable; and (e) any HUD-certified housing counselor.

 

 

Borrower Signature

 

 

Date

 

 

 

 

 

 

 

 

 

Co-Borrower Signature

 

 

Date

 

 

 

 

 

 

 

 

 

 

 

HOMEOWNER’S HOTLINE

 

If you have questions about the program that your servicer cannot answer or need further counseling, you can call the Homeowner’s HOPEan help with questions about

NOTICE TO BORROWERS

Be advised that by signing this document you understand that any documents and information you submit to your servicer in connection with the Making Home Affordable Program are under penalty of perjury. Any misstatement of material fact made in the completion of these documents including but not limited to misstatement regarding your occupancy in your home, hardship circumstances, and/or income, expenses, or assets will subject you to potential criminal investigation and prosecution for the following crimes: perjury, false statements, mail fraud, and wire fraud. The information contained in these documents is subject to examination and verification. Any potential misrepresentation will be referred to the appropriate law

enforcement authority for investigation and prosecution. By signing this document you certify, represent and agree that: “Under penalty of perjury, all documents and information I have provided to Lender in connection with the Making Home Affordable Program, including the documents and information regarding my eligibility for the program, are true and correct.”

If you are aware of fraud, waste, abuse, mismanagement or misrepresentations affiliated with the Troubled Asset Relief Program, please contact the SIGTARP Hotline by calling 1-877-SIG-2009 (toll-free), 202-622-4559 (fax), or www.sigtarp.gov. Mail can be sent to Hotline Office of the Special Inspector General for Troubled Asset Relief Program, 1801 L St. NW, Washington, DC 20220.

page 3 of 3

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This form requires specific information; in order to guarantee accuracy, you should consider the subsequent tips:

1. It is very important complete the modification request properly, so be mindful while working with the sections containing these blanks:

making home affordable modification form conclusion process described (part 1)

2. The subsequent part is to fill out all of the following blank fields: Is the property listed for sale, Have you contacted a, Who pays the real estate tax bill, Who pays the hazard insurance, Have you iled for bankruptcy Yes, Additional LiensMortgages or, Lien Holders NameServicer, Balance, Contact Number, Loan Number, HARDSHIP AFFIDAVIT, I am having diiculty making my, I We amare requesting review under, My household income has been, and My monthly debt payments are.

Part no. 2 in submitting making home affordable modification form

3. In this step, have a look at My expenses have increased For, My cash reserves including all, Other, Explanation continue on back of, and page of. Every one of these have to be completed with highest accuracy.

Filling out section 3 of making home affordable modification form

People who work with this document generally make some errors while filling in Explanation continue on back of in this area. Be sure you re-examine whatever you enter right here.

4. To go forward, this fourth stage involves filling out a couple of blank fields. Examples include REQUEST FOR MODIFICATION AND, COMPLETE ALL THREE PAGES OF THIS, INCOMEEXPENSES FOR HOUSEHOLD, Number of People in Household, Monthly Household Income, Monthly Household ExpensesDebt, Household Assets, Monthly Gross Wages, Overtime, Child Support Alimony Separation, Social SecuritySSDI, Other monthly income from pensions, Tips commissions bonus and, Rents Received, and Unemployment Income, which you'll find vital to going forward with this particular document.

making home affordable modification form conclusion process explained (portion 4)

5. This pdf needs to be wrapped up with this particular section. Here there's a comprehensive list of form fields that need accurate details for your document submission to be faultless: Food StampsWelfare, Other investment income royalties, Car Payments, Other, Other, Do not include the value of life, Total Gross Income, Total DebtExpenses, Total Assets, Include combined income and, member who is not a borrower, You are not required to disclose, INCOME MUST BE DOCUMENTED, INFORMATION FOR GOVERNMENT, and The following information is.

Stage # 5 of submitting making home affordable modification form

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