Irs Tax Delinquent Mortgages - DOC

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					                                      Piedmont Housing Alliance
                                         111 Monticello Ave., Suite 104
                                           Charlottesville, VA 22902
                                   Office: 434-817-2436 * Fax: 434-817-0664
                           Default/Delinquency/Foreclosure Counseling Process
Pied mont Housing Alliance provides comprehensive homeownership counseling for clients in a default/delinquency or foreclosure
situation. Our goal through one-on-one confidential counseling is to listen to you to determine your concerns, motivations and
capability to analyze the available options. We do not have funds to help bring your mortgage current. Default counseling is a
cooperative process where the counselor acts as a facilitator rather than a lending expert. Listed below is an overview of th e process
and steps fro m Pied mont Housing Alliance Defau lt/Delinquency/Foreclosure Counseling:

Step 1 – Intake
    A) Initial Interview
    B) Overview of the Co mpleted of Intake Fo rm, Authorization to obtain information, Spending Plan and review of Credit Report.
    C) Determine the borrowers desire to keep the home
    D) Review of gathered Documentation:
        Copies of 1 years IRS tax returns and corresponding W -2s
        Copies of 30 days Pay stubs and/or proof of alternative income (child or spousal support)other than employ ment (if
        Copy of divorce decree (if applicable)
        Copy of bankruptcy documents (if applicable)
        Copy of all mo rtgage loan correspondence, loan documents and current statement , Deed of Trust
        Copy of all b ills (cred it cards, personal loans, cable, telephones, etc.)
    E) Cred it Report Rev iew and Financial Situation Su mmary

Step 2 – Action Planning
    A) Review of the Counselors Analysis Gu ide
        Determine if the financial hardship is curable or incurable (what caused the inability to pay, review of spending plan,

Step 3 – If Curable
    A) Determining the realistic options (is the delinquency curable and does the borrower have the future ability to repay the debt)
    B) Review curable options (contacting lender, setting up repayment options, hardships letters, etc.)

Step 4 – If not Curable
    A) An overview of Fo reclosure Process
    B) An overview of the options available (straight sale, pre-foreclosure sale, deed-In Lieu)

Step 5 – Options
Acceptance, I understand the services being offered and agree to participate in the Piedmont Housing Alliance’s
Default/Delinquency/Foreclosure Program. Piedmont Housing Alliance agrees to provide these services without regard to race, color,
religion, national origin, gender, elderliness, familial status, or disability.

____________________________________________                            ________________________________________
Applicant (s)                                     Date                  Certified Housing Counselor                  Date

Applicant (s)                               Date

PHA is a HUD and Freddie Mac Certified Housing Counseling Agency and an Equal Opportunity Housing Organizati on.

                                DEFAULT/DELINQUENT/PREDATORY FORM
Borro wer’s Name_______________________________              Co-Borro wer’s Name_____________________________

Social Security Nu mber_____________________                 Social Security Nu mber_____________________

Date of Birth____________Home Phone________________          Date of Birth____________Home Phone________________

Work Phone__________________Cell Phone____________           Work Phone__________________Cell Phone____________

Email Address___________________________________             Email Address_____________________________________

Are you a US citizen :____ Race:______________________       Are you a US citizen :____ Race:_______________________

Ethnicity:__Non-Hispanic __Hispanic                          Ethnicity:____Non-Hispanic ____Hispanic

Total number of Dependents in Household _____

Age/relationship of dependents:____________________


Mailing Address__________________________________________________________________________________________

Property Address_________________________________________________________________________________________

Property Jurisdiction___________________

Do you occupy the property?_____________Is it a rental property?_____________Is it leased?____________________
SOURCES OF INCOME (Include social security, disability, child support, etc.)

Borrower’s Employer_____________________                     Co-Borrower’s Employer____________________

Employer’s Jurisdiction___________________                   Employer’s Jurisdiction___________________

No. of Months Employed____ Start Date_________               No. of Months Employed____ Start Date_________

Job Title:__________________________________                 Job Title:_________________________________

Pay schedule: Weekly____ Bi-weekly____ Twice                 Pay schedule: Weekly____ Bi-weekly____ Twice

a Month____ Monthly____                                      a Month____ Monthly____

Monthly Income-(Gross-before taxes)_________                 Monthly Income-(Gross-before taxes)_________

Yearly Income-(Gross-before taxes)__________                 Yearly Income-(Gross-before taxes)__________

If unemployed, date of last pay check_________               If unemployed, date of last pay check_________

Other income (SSI, Disability)_______________                Other income (SSI, Disability) _______________

Number of Months Received________________                    Number of Months Received________________

AVAILABLE ASSETS (List all cash available such as saving, cre dit union accounts, stocks or 401K
plans, gifts from family/friends) for both borrower and co-borrowe r
Include social security, disability, child support, etc.)
Financial Institute/Source            Type of Account/Funds          Estimated Amount Available

DEBT (List all debts such as house mortgage, car payments, loans, payday loans, child support or
credit cards) for both borrowe r and co-borrower
Creditor                                Monthly Payment                       Remaining Balance

Do you have any outstanding liens or collection? ___ If yes, what is the total amount due? ______________

Have you ever filed bankruptcy? ____ If yes, what is the current status: ____________________

Have you ever attended any Homeownership Courses or classes, if yes, where and when?


Inability to Pay Mortgage:
I am having difficulty making my monthly payment because of financial difficulties created by
 (Please check all that apply)
__Business Failure                           __Incarceration                    __Other:_________________
__Curtailment of Income                      __Marital Difficulties
__Death in Family                            __Military Service
__Death of Borrower                          __Payment Adjustment
__Distant Employment Transfer                __Payment Dispute
__Excessive Financial Obligations            __Property Problems
__Fraud                                      __Title Problems
__Illness in Family                          __Transferring Property
__Illness of Borrower                        __Unemployment
__Inability to Rent Property

I believe that my situation is: __Short Term (under 6 months)    __Long Term (over 6 months)    __Permanent

I want to:      __Keep the Property             __Sell the Property


 Current Lender or Servicer________________________ Loan Account Number __________________
 Lender telephone number___________________________Lender fax number_______________
 Have you talked to the Lender about your inability to pay?_________ When:__________________
 Month and Year Mortgage obtained ____________
 Type of Mortgage: ___Purchase       ___Refinance- if checked, year of original loan__________
 Original Sales Price______________________                Current Loan Amount__________________
 Investor/Insurer, if any: ___HUD Insured    ___VA      ___Rural Development      ___Fannie Mae
                         ___Freddie Mac      ___PMI, Company name____________________________
                         ___Other            ___VHDA

 Total Monthly Payment_________
 Does payment include escrow for taxes and insurance?________
 If no, are your taxes and insurance current?________
 Month of last payment that was made on time_____________ Total amount past due_____________
 Loan type: ___ 30 year fixed, interest rate______
              ___Adjustable interest rate, current rate_______ How often will it adjust?___________

 Are there any other mortgages/home equity loans/liens on the property?________
 If yes, list mortgage holders:__________________________________________________________
 What are the monthly payments?________________How many months behind?_________________
 Is the property listed for sale?_____Date Listed_____________

 Current Sales Price____________________Current Assessed Value_____________________

 If yes, Real Estate Agent’s Name__________________________Real Estate Company_________________

 Real Estate Agent’s Phone Number_______________Agent’s email______________________

Additional Notes:


I/WE certify that all of the above information is correct and true to the best of my knowledge. I understand that
the information obtained is to be used in assessing my readiness for the eligibility for programs and services at
Piedmont Housing Alliance. I understand that false or misleading information will affect my ability to purchase
a home. I also understand that the completion of this form in no way guarantees assistance with housing and
pulling this credit report will result in an Inquiry listed on my credit report.

I hereby authorize Piedmont Housing Alliance to obtain a credit report in my/our name.
This also AUTHORIZES Piedmont Housing Alliance, including staff members and any authorized
representative or associated agency of Piedmont Housing Alliance, to receive information or make inquiries on
my personal and financial information including, but not limited to, my income, employment, credit report, and
all creditors.


       Print Name

       Current Address

       Social Security #

       Loan Number
       Mortgage Servicer

       Date of Birth

       Today’s Date


       Print Name

       Current Address

       Social Security#

       Date of Birth

       Today’s Date

                       PHA is a HUD and Freddie Mac Certified Housing Counseling Agency
                                    is an Equal Opportunity Housing Organization

                                              HOUSEHOLD SPENDING PLAN

Indicate # of people in household:                                            FLEXIBLE EXPENS ES
 Adults                       Children
 NET MONTHLY INCOME                                                        Groceries
                                                                           Lunch (work/school)
 Source 1                                                                  Eating Out
 Source 2                                                                  Entertainment/Hobbies
 Other Income                                                              Laundry/Drycleaning
 Total Income (A)                                                          Cleaning Supplies
 FIXED EXPENS ES                                                           Gasoline/Bus/Taxi
                                                                           Newspaper/M agazines
 Rent/M ortgage                                                            Alcohol/Cigarettes
 Electric                                                                  Church/Charity
 Gas/Oil                                                                   Tuition/Books
 Water/Sewer                                                               Barber/Beauty Shop
 Telephone (basic)                                                         Auto M aintenance
     long distance                                                         House M aintenance
     cellular/pager                                                        Doctor/Dentist
 Trash pickup                                                              Pets
 Cable                                                                     Parking/Tolls
 M edical Insurance                                                        Lottery/Bingo
 Auto Insurance                                                            Other
 Life Insurance                                                            Total (D)
 Renters Insurance
 Child Support/Alimony                                                     Expenses
 Child Care                                                                FIXED (B)
 Other                                                                     CREDITOR (C)
 Total (B)                                                                 FLEXIBLE (D)
                                                                           TOTAL EXPENS ES (E)

 Install Loans                                                             Subtract Expenses from Income (A – E):
                                                                           TOTAL INCOM E (A)
 Automobile Loan(s)                                                        TOTAL EXPENSES (E)
                                                                           DIFFERENCE + or -
 Total Payments (C)

 Applicant Signature                                                                 SSN#

 Applicant Signature                                                                 SSN#

 CERTIFICATION: I hereby certify that I have reviewed the above spending plan with the applicant(s) and concur that it is reasonable.

 Lender or Counselor Signature:

                         Foreclosure Mitigation Counseling Agreement

      1. I understand that Piedmont Housing Alliance provides foreclosure mitigation counseling after
         which I will receive a written action plan consisting of reco mmendations for handling my
         finances, possibly including referrals to other housing agencies as appropriate.
      2. I understand that Piedmont Housing Alliance receives Congressional funds through the National
         Foreclosure Mitigation Counseling (NFMC) program and, as such, is required to share some of
         my personal information with NFMC program administrators or their agents for purposes of
         program monitoring, compliance and evaluation.
      3. I give permission for NFMC program administrators and/or their agents to pull my credit report
         up to two additional times between now and June 30, 2010 and to give authorization for NTMC
         program administrators and/or their agents to follow- up with me between now and June 30, 2010
         for the purposes of program evaluation.
      4. I acknowledge that I have received a copy of Piedmont Housing Alliance’s Privacy Policy.
      5. I may be referred to other housing services of the organization or another agency or agencies as
         appropriate that may be able to assist with particular concerns that have been identified. I
         understand that I am not obligated to use any of the services offered to me.
      6. A counselor may answer questions and provide information, but not legal advice. If I want legal
         advice, I will be referred for appropriate assistance.
      7. I understand that Piedmont Housing Alliance provides information and education on numerous
         loan products and I further understand that the housing counseling I receive from Piedmont
         Housing Alliance in no way obligates me to choose any of these particular loan products or
         housing programs.


By:                                                  Date ____________________________

By: _________________________________                Date ____________________________


By: _________________________________                Date ____________________________

                                     Piedmont Housing Alliance Privacy Policy

        Piedmont Housing Alliance is committed to assuring the privacy of individuals and/or families who
have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We
assure you that all information shared both orally and in writing will be managed within legal and ethical
considerations. Your “nonpublic personal information,” such as your financial circumstances, will be provided
to creditors, program monitors, and others only with your authorization and signature on the Foreclosure
Mitigation Counseling Agreement. We may also use anonymous aggregated case file information for the
purpose of evaluating our services, gathering valuable research information and designing future programs.

       Types of information that we gather about you
        Information we receive from you orally, on applications or other forms, such as your name, address,
          social security number, assets, and income;
        Information about your transactions with us, your creditors, or others, such as your account balance,
          payment history, parties to transaction and credit card usage; and
        Information we receive from a credit reporting agenc y, such as your credit history.

       You may opt-out of certain disclosures
        You have the opportunity to “opt-out” of disclosures of your nonpublic personal information to third
          parties (such as your creditors), that is, direct us not to make those disclosures.
        If you choose to “opt-out”, we will not be able to answer questions from your creditors. If at any
          time, you wish to change your decision with regard to your “opt-out”, you may call us at 434-817-
          2436 and do so.

       Release of your information to third parties
        So long as you have not opted-out, we may disclose some or all of the information that we collect, as
          described above, to your creditors or third parties where we have determined that it would be helpful
          to you, would aid us in counseling you, or is a requirement of grant awards which make our services
        We may also disclose any nonpublic personal information about you or former customers to anyone
          as permitted by law (e.g., if we are compelled by legal process).
        Within the organization, we restrict access to nonpublic personal information about you to those
          employees who need to know that information to provide services to you. We maintain physical,
          electronic and procedural safeguards that comply with federal regulations to guard your no npublic
          personal information.


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