S.P.O.C.H.
Confidential Application for Foreclosure Workout Assistance
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Your Lender can't speak with us unless and/or until you have given them your written permission.   When you have completed this form, a Letter or Letters of Authorization will be prepared automatically.  Please print the completed form and the Letter(s) of Authorization so that we can move to the next step.   If you have any questions, or need help completing the form, please email your troubled loan consultant.
 
Borrower
First Name:
Last Name:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Home Phone #:
Work Phone #:
E-Mail Address:
 
Property
Estimated Property Taxes: $
Estimated Fair Market Value: $
Describe House and Condition:
 
First Mortgagee
Mortgagee Name:
Mortgage Loan #:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Phone # (Toll free preferred):
Fax #:
Contact's Name:
Contact's Direct Phone #:
Approximate Loan Balance: $
Date You Made Last Payment:
Monthly Payment: $
Taxes Included In Above Amount?: Yes      No
Property In Foreclosure?: Yes      No
Property Listed For Sale?: Yes      No
Broker (If For Sale)?:
Currently In Bankruptcy?: Yes      No
Briefly Describe What Caused The Default And What You Wish To Do:
 
Second Mortgagee
Mortgagee Name:
Mortgage Loan #:
Address Line 1:
Address Line 2:
City:
State:
Zip Code:
Phone # (Toll free preferred):
Fax #:
Contact's Name:
Contact's Direct Phone #:
Approximate Loan Balance: $
Date You Made Last Payment:
Monthly Payment: $
Taxes Included In Above Amount?: Yes      No
Property In Foreclosure?: Yes      No
Property Listed For Sale?: Yes      No
Broker (If For Sale)?:
Currently In Bankruptcy?: Yes      No
Briefly Describe What Caused The Default And What You Wish To Do:
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