Getting Started – Step 1

Information Worksheet

This is a two-step process; completing step 1 will take approximately 10 – 15 minutes.
Step 2 will take about 15 – 30 minutes to complete.
If you prefer, you may download these forms and mail or fax them to us.

Download Step1 (PDF)
Download Household Budget Worksheet (Microsoft Excel Document)

Homeowner Information
Primary Borrower
Phone
Address
City
State	Choose a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNewHampshireNewJerseyNewMexicoNewYorkNorthCarolinaNorthDakotaOhioOklahomaOregonPennsylvaniaRhodeIslandSouthCarolinaSouthDakotaTennesseeTexasUtahVermontVirginiaWashingtonWestVirginiaWisconsinWyoming
Zip Code
Email 1
Email 2
Age
Gender	M F
Race
Hispanic or Latino	Y N
Number in household
Yearly Gross Household Income
Married	Y N

Mortgage Information
Mortgage 1
Lender
Loan number
Mortgage 2
Lender
Loan Number
Type and Interest Rate of Current First Mortgage Loan:
Fixed Rate under 8% Adjustable Rate Mortgage (ARM) under 8% Fixed Rate equal to 8% or greater Adjustable Rate Mortgage (ARM) over 8% Fixed Interest Rate Loan
Current Loan Information for First Mortgage ONLY: (please answer Yes or No)
Interest Only Payment Y N	VA or FHA Insured? Y  N
Hybrid Loan (ex. 2/28, 3/27) Y  N	Privately Held Mortgage? Y N
Option ARM (pick-a-pay)? Y  N	Has your ARM loan reset or adjusted? Y  N
Current Loan Status
Current Late 30-60 61-90 1-120 120+
Default Reason
Reduction in income Increase in Expenses Poor budget management skills Divorce/Separation Loss of income Death of family member Medical Issues Business Venture failed Other Increase in loan payment
Have you worked with an agency or company (non-profit or for-profit) to get assistance?
Yes No If so, name of company

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