Uniform Borrower Assistance Form PDF Details

In today's complex financial landscape, numerous homeowners find themselves facing challenging circumstances that make it difficult to keep up with mortgage payments. Recognizing this, the Uniform Borrower Assistance Form (UBAF) serves as a crucial tool for those seeking to navigate temporary or long-term financial hardships. This comprehensive document requires borrowers to provide detailed information about their current situation, including their intentions regarding their home, the property's status, real estate taxes, homeowner's insurance premiums, bankruptcy filings, credit counseling involvement, and any additional liens on the property. Furthermore, the form delves into the borrower's income, expenses, and assets, offering a holistic view of their financial standing. Submission of this form, alongside required income and hardship documentation, initiates the evaluation process for various mortgage relief solutions, such as modification, forbearance, or other assistance programs tailored to prevent foreclosure. By signing the UBAF, borrowers must certify the truthfulness of the provided information, which is subject to verification by the servicer or authorized parties, underlining the seriousness and legal implications of the assistance request process. Through this form, borrowers are given the opportunity to articulate their hardship and seek appropriate relief measures, illustrating a structured approach to addressing financial distress and fostering a pathway toward resolution.

QuestionAnswer
Form NameUniform Borrower Assistance Form
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesuniform borrower assistance form 2019, uniform borrower assistance form 2018, uniform borrower assistant form, universal form 710 october 2016

Form Preview Example

Loan Number: 1004848

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) information on the property's status; (3) real estate taxes; (4) homeowner's insurance premiums; (5) bankruptcy; (6) your credit counseling agency, and (7) information concerning other liens, if any, on your property.

On Page 2, you must disclose information about all of your income, expenses, and assets. Page 3 also lists the required income documentation that you must submit in support of your request for assistance. Then on Page 4, you must complete the Hardship Affidavit in which you disclose the nature of your hardship. It also tells you 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.

 

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: John Loan Mod

 

 

 

CO-BORROWER'S NAME: Jane Smith

 

 

 

SOCIAL SECURITY

 

DATE OF BIRTH

NO. OF

 

 

SOCIAL SECURITY

 

DATE OF BIRTH

NO. OF

 

NUMBER

 

Sep 12, 1978

DEPENDENTS:

 

NUMBER

 

Sep 20, 1978

DEPENDENTS:

 

678 - 68 - 8767

 

 

 

 

 

 

678 - 68 - 8767

 

 

 

 

 

 

HOME PHONE NUMBER WITH AREA CODE

 

 

 

HOME PHONE NUMBER WITH AREA CODE

 

 

 

(342) 534 - 3425

 

 

 

 

 

 

(523) 453 - 2534

 

 

 

 

 

 

CELL OR WORK NUMBER WITH AREA CODE

 

 

CELL OR WORK NUMBER WITH AREA CODE

 

 

(305) 606 - 2360

 

 

 

 

 

 

(234) 324 - 3243

 

 

 

 

 

 

MAILING ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

1111 1st St, New Roads, LA 12121.

 

 

 

 

 

 

 

 

 

 

 

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

EMAIL ADDRESS

 

 

 

 

1111 1st St, New Roads, LA 12121.

 

 

 

 

craig@pixelfusion.com

 

 

 

 

 

 

 

 

 

 

Is the property listed for sale?

 

Yes

No

 

Have you contacted a credit-counseling agency for help?

 

If yes:

 

 

 

 

 

 

 

 

 

 

Yes

No

 

what was the listing date? ___________________

 

 

If yes:

 

 

 

 

 

 

Have you received an offer on the property?

 

 

 

Counselor's Name: John SMoth

 

 

 

 

 

 

 

 

Yes

No

 

Agency's Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

_______________________________________________

 

Date of offer: ___________________

 

 

 

Counselor's Phone Number: (987) 897 - 9879 Ext 89789

 

Amount of Offer: $ 0.00

 

 

 

 

 

Counselor's Email Address:

 

 

 

 

Agent's Name:

 

 

 

 

 

john@counselor.com

 

 

 

 

Agent's Phone Number:

 

 

 

 

_______________________________________________

 

Is the property for sale by owner?

 

Yes

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Do you have condominium or

 

Yes

No

 

Have you filed for bankruptcy?

 

Yes

No

 

homeowner association (HOA) fees?

 

 

 

If yes:

 

 

 

 

 

 

If yes: Total monthly amount: $ 100.00

 

 

 

Chapter 7

Chapter 11

Chapter 12

Chapter 13

 

Amount Past Due: $ __________________

 

 

Filing date: ___________________

 

 

 

Name and address fees are paid to:

 

 

 

Has your bankruptcy been discharged?

Yes

No

 

______________________________________________

 

 

 

 

 

 

 

 

__________________________________________

 

Bankruptcy case number:

___________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Updated February 2013

F054D

Page 1 of 5

Loan Number: 1004848

Is any borrower an active duty service member?

 

 

 

 

 

 

 

Yes

No

Is any borrower the spouse or dependent of an active duty service member?

 

 

 

 

Yes

No

Has any borrower been deployed away from his/her primary residence or recently received a Permanent Change of

Yes

No

Station order?

 

 

 

 

 

 

 

 

 

 

 

Is any borrower the surviving spouse of a deceased service member who was on active duty at the time of death?

Yes

No

Is any borrower a dependent of a deceased service member who was on active duty at the time of death?

Yes

No

 

 

 

 

 

 

 

 

 

Monthly Household Income

 

 

 

Household Assets (associated with

 

 

 

 

 

 

 

 

the property and/or borrower(s)

 

Gross wages

 

 

 

$4,400.00

 

Checking Account(s)

 

 

$3,400.00

 

 

 

 

 

 

 

 

 

 

 

 

Overtime

 

 

 

$0

 

Checking Account(s)

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

Child Support / Alimony*

 

 

 

$0

 

Savings / Money Market

 

 

$1,000.00

 

 

 

 

 

 

 

 

 

 

 

 

Non-taxable social security/SSDI

 

$0

 

CDs

 

 

$

 

 

 

 

 

 

 

 

 

 

 

 

Taxable SS benefits or other monthly income from

 

$0

 

Stocks / Bonds

 

 

$0

annuities or retirement plans

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Tips, commissions, bonus and self-employed income

$0

 

Other Cash on Hand

 

 

$200.00

 

 

 

 

 

 

 

 

 

 

 

Rents Received

 

 

 

$0

 

Other Real Estate (estimated value)

 

$0

 

 

 

 

 

 

 

 

 

 

 

 

Unemployment Income

 

 

 

$0

 

Other_____________

 

 

$374,000.00

 

 

 

 

 

 

 

 

 

 

 

 

Food Stamps/Welfare

 

 

 

$0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Other_____________

 

 

 

$0

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total (Gross income)

 

 

 

$4,400.00

 

Total (assets)

 

 

$378,600.00

 

 

 

MONTHLY HOUSEHOLD EXPENSES/DEBT

 

 

 

Monthly Debt Expenses

 

 

 

 

 

Monthly Household Expenses

 

 

First mortgage payment

$1,872.96

 

Cable

 

 

 

$50.00

 

Tuition

 

$0

 

 

 

 

 

 

 

 

 

Second mortgage payment

$0

 

Bankruptcy trustee

 

$

 

Gas / fuel / oil for vehicle

$

 

 

 

payments

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Homeowner's Insurance

$237.11

 

Bus / transit / parking

 

$0

 

Ground rent / land lease

 

$

 

 

 

 

 

 

 

 

 

 

Property taxes

$110.00

 

Internet

 

$0

 

Health insurance

 

$150.00

 

 

 

 

 

 

 

 

 

 

Credit cards / installment

$325.00

 

Charitable giving

 

$0

 

Medical bills

 

$0

loans(total minimum

 

 

 

 

 

 

 

 

 

 

 

payment / mo.)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Car lease payments

$125.00

 

Child care

 

$155.00

 

Life insurance

 

$

 

 

 

 

 

 

 

 

 

 

HOA/condo fees/property

$100.00

 

Clothes

 

$0

 

Prescriptions

 

$

maintenance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mortgage payments on

$0

 

Entertainment

 

$325.00

 

Phones (land and/or cell)

$0

other properties

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Alimony payments

 

 

Legal / court costs

 

$

 

Food

 

$0

 

 

 

 

 

 

 

 

 

Child support payments

$0

 

Tax payments

 

$

 

Gas / electricity / fuel oil /

$0

 

 

 

 

 

 

 

 

 

water / sewer / garbage

 

 

 

 

 

 

 

 

 

 

 

 

Other

$0

 

Vehicle insurance

 

$350.00

 

Other

 

$0

 

 

 

 

 

 

 

 

 

Total (debt expenses)

 

 

Total (household expenses)

 

 

$3,800.07

 

 

 

 

 

 

 

 

 

 

 

 

Updated February 2013

F054D

Page 2 of 5

Loan Number: 1004848

If subordinate lien(s) or any other lien(s) exist on the subject property, please enter information on the lien(s) below:

Lien Holder's Name:

Balance and Interest Rate:

Loan Number:

Lien Holder's Phone Number:

__________________________

0.00/1.000

_________________________

 

__________________________

 

 

 

__

 

 

 

 

/

 

 

 

 

 

 

 

/

 

 

 

REQUIRED INCOME DOCUMENTATION

 

Do you earn a salary or hourly wage?

For each borrower who is a salaried employee or paid by the hour, include paystub(s) reflecting the most recent 30 days' earnings and documentation reflecting year-to-date earnings, if not reported on the paystubs (e.g. signed letter or printout from employer).

Are you self-employed?

For each borrower who receives self employed income, include a complete, signed individual federal income tax return and, as applicable, the business tax return; AND either the most recent signed and dated quarterly or year-to-date profit/loss statement that reflects activity for the most recent three months; OR copies of bank statements for the business account for the last two months evidencing continuation of business activity.

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., 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.

Updated February 2013

F054D

Page 3 of 5

Loan Number: 1004848

HARDSHIP AFFIDAVIT

I am requesting review of my current financial situation to determine whether I qualify for temporary or permanent mortgage relief options.

Date Hardship Began is: May 10, 2012

Has your hardship ended? No

Yes If yes, what date was it resolved? ___________________________

 

 

 

My hardship situation is:

 

 

 

 

 

Short-term (under 6 months)

Medium-term (6-12 months)

Long-term or Permanent

 

 

(greater than 12 months)

I am having difficulty making my monthly payment because of reasons set forth below: (Please check all that apply and submit required documentation demonstrating your hardship)

If Your Hardship is:

Then the Required Hardship Documentation is:

Unemployment

No hardship documentation required

 

 

Reduction in Income: a hardship that has caused a

No hardship documentation required

decrease in your income due to circumstances outside

 

your control (e.g., elimination of overtime, reduction in

 

regular working hours, a reduction in base pay)

 

Increase in Housing Expenses: a hardship that has

No hardship documentation required

caused an increase in your housing expenses due to

 

circumstances outside your control

 

Divorce or legal separation; Separation of

Divorce decree signed by the court; OR

Borrowers unrelated by marriage, civil union or similar

Separation agreement signed by the court; OR

domestic partnership under applicable law

Current credit report evidencing divorce, separation, or non-occupying borrower

 

has a different address; OR

 

Recorded quitclaim deed evidencing that the non-occupying Borrower or

 

co-Borrower has relinquished all rights to the property

Death of a borrower or death of either the primary

Death certificate; OR

or secondary wage earner in the household

Obituary or newspaper article reporting the death

Long-term or permanent disability; Serious illness

Doctor's certificate of illness or disability; OR

of a borrower/co-borrower or dependent family

Medical bills; OR

member

Proof of monthly insurance benefits or government assistance (if applicable)

Disaster (natural or man-made) adversely

Insurance claim; OR

impacting the property or Borrower's place of

Federal Emergency Management Agency grant or Small Business

employment

Administration loan; OR

 

Borrower or Employer property located in a federally declared disaster area

Distant employment transfer / Relocation

For active-duty service members: Notice of Permanent Change of Station (PCS)

 

or actual PCS orders.

 

For employment transfers/new employment:

 

Copy of signed offer letter or notice from employer showing transfer to a new

 

employment location; OR

 

Pay stub from new employer; OR

 

If none of these apply, provide written explanation

 

In addition to the above, documentation that reflects the amount of any relocation

 

assistance provided, if applicable (not required for those with PCS orders).

Business Failure

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 recent bank statements for the business account evidencing cessation of business activity; or

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

Other: a hardship that is not covered above

Written explanation describing the details of the hardship and relevant

 

documentation

Updated February 2013

F054D

Page 4 of 5

Loan Number: 1004848

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.

*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.

_______________________

__________

_______________________

__________

Borrower Signature

Date

Co-Borrower Signature

Date

Updated February 2013

F054D

Page 5 of 5