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Foreclosure Intervention Intake Form

Foreclosure Intervention Intake Form

BORROWER INFORMATION

1% Complete

Date: 12/9/2016

CO-BORROWER

12% Complete

PROPERTY INFORMATION

23% Complete

FIRST MORTGAGE

34% Complete

SECOND MORTGAGE

45% Complete

MONTHLY INCOME

56% Complete

Borrower

MONTHLY EXPENSES (DO NOT INCLUDE INFORMATION ON RENTAL PROPERTIES)

67% Complete

CREDIT CARDS AND LOANS (CAR, STUDENT, PAYDAY)

78% Complete
Lender Name Account Type Balance Monthly Payment

LIQUID ASSETS

89% Complete
Description Value