Real Estate Fraud Report - Orange County District Attorney

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Real Estate Fraud Report                                                                      Submit by E-mail
          Date:

Reported By:                      (Please indicate address and phone where you can be reached)
   Your Name:                                                                                                     Office of the District Attorney
                                                                                                                      Orange County, California
           DOB:                                            Driver's License #:                                       Real Estate Fraud Unit - 5th Floor
                                                                                                                                           PO Box 808
       Address:                                                                                                                  Santa Ana, CA 92701
                                                                                                                                 Phone: 714-834-3600
City, State, Zip:                                                                                                                   Fax: 714-568-1250
                                                                                                                           www.orangecountyda.com
 Home Phone:                                               Mobile Phone:

       This form and any materials you provide may be subject to discovery and used in court in a
      criminal prosecution and you may be examined or cross-examined on the facts you provide.
This report/complaint is about:                     Real Estate Purchase          Real Estate Sale        Loan Modification

 Name of Business and/or Person:
      Identifying Information:
      (i.e. License #s, employer, etc.)
       Address:

City, State, Zip:

        Phone:                                             Mobile Phone:

Information about the problem transaction:
Starting Date:                                                      City/State of Transaction:

     Full Address of Property
  involved in this transaction:

For Loan Modification: Was there a notice of default?                  Yes          No Date of Default Notice:

Amount of Loss:                                       Paid By:         Cash         Check      Money Order Other:
                                                                       Wire Transfer           Credit Card
Did you sign a contract?          Yes          No

Date Contract Signed:                                               Contract Signed in City/State:


Was the product or                                                                                             Were you solicited
                            Yes           No    Type of Advertisement:                                                                 Yes      No
service advertised?                                                                                                   by Phone?

Location of Advertisement:                                                             Date of Advertisement:


Have you complained to the company or person?                 Yes        No      Complained by:         Phone       Mail     e-mail       In Person
Name/Title of Person Contacted:                                                                        Date:


How did the person/company respond?

Other actions you have taken:
     Reported to another Agency:
(Agency Name, contact, and case #)
     Consulted Attorney/Legal Aid:
       (Attorney Name, contact #)
           Court Action is Pending:
    (Court, Case #, next court date)
                                Other people involved in this transaction:

Who was your real estate agent, Loan Modification Officer or broker in the transaction? (if applicable)
Name(s):

Address:

Phone(s):


Who was the Lender/Investor in the transaction? (if applicable)
Name(s):

Address:

Phone(s):


Who was the Title Company in the transaction? (if applicable)
Name(s):

Address:

Phone(s):


Who was the Buyer in the transaction? (if applicable)
Name(s):

Address:

Phone(s):


Who was the Seller in the transaction? (if applicable)
Name(s):

Address:

Phone(s):


Who was the attorney and Law Firm that you dealt with? (Loan Modification - if applicable)
Name(s):

Address:

Phone(s):


Other people, businesses or witnesses to the transaction:
Name(s):

Address:

Phone(s):


   your Name:
Brief description
of what you
experienced




What actions do
you believe are
illegal?




If this report is investigated, and criminal charges are filed against the suspect, you may be required to
appear in Court to testify truthfully to the allegations in this report. Will you do this if needed?

   Yes        No    Give Reason:




Note: Section 148.5(a) of the California Penal Code states:

         "Every person who reports to any peace officer listed in section 830.1 or 830.2, district
         attorney, or deputy district attorney that a felony or misdemeanor has been committed,
         knowing the report to be false, is guilty of a misdemeanor."

I declare under penalty of perjury under the laws of the State of California that a
felony or misdemeanor has been committed, and that the foregoing statements and
photocopies of attached documents are true and correct.

Date:
                                      Signature:



                                      Print Full Name:



                                      Your Date of Birth:
             List of Events - In order from earliest to current date
   Date               Description of what happened, actions, contacts, events




Your Name:
List of Events - Continued
       Date                           Description of what happened




Download additional pages if needed

Your Name:

				
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