Please complete this form as completely and accurately as possible.
First Name :
Last Name :
Address :
City :
State :
Zip Code :
Primary Phone :
Cell phone :
Work phone :
Fax :
Comments :
Email Address :
Subdivision :
Property Type :
Date of last payment :
Is the property set for public auction or foreclosure date? :
Have you received a formal notice of default from the bank? :
Is the property currently listed with a realtor? :
Have you had any offers? :
Have you had any communications with the lender? :
Have you attempted a short sale or loan modification of any type? :
What is the last contact that you had with the lender? :
Have you sent the lender any documentation? :
If yes, when and what type? :
Have you been behind in the payments on this property previously? :
What is the name of the lender on the 1st mortgage? :
What is the payment on the 1st mortgage? :
What is the loan number of the 1st mortgage? :
What is the name of the lender on the 2nd mortgage? :
What is the payment on the 2nd mortgage? :
What is the loan number of the 2nd mortgage? :
Are there any other payments, liens or encumbrances? How much? :
What is the occupancy status of the property? :
If vacant, how long has it been vacant? :
If there is a Tenant, are they paying rent? :
How long has the Tenant been there? :
What is the current monthly rent payment? :
Describe if the tenant pays on time, are there any rental problems, etc.? :
What is the general condition of the property? :
Are all of the appliances currently at the property and in working order? :
Are all cabinets, heater, a/c, other fixtures at the property and in working order? :
Does the property need new flooring or paint? :
Does the property need any repairs over $150? :
 
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