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| Required fields are marked with an asterisk * |
| * First Name: |
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| Last Name: |
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| * Direct Email: |
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| * Direct Phone: |
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| Best Time To Call: |
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| Is there a specific time and day you would like us to call: |
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| How did you hear about NAFPP? |
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| What are your immediate goals? |
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| Have you received a Foreclosure notice? |
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| If yes, what date did you receive the notice? |
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| Have you received notice of your Court Hearing Date? |
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(Note: This does not apply to all states) |
| If yes, when is the Court Hearing Date? |
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| Have you received notice of a Sheriff Sale? |
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| If yes, when is the Sheriff Sale? |
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| (Note: The Sheriff Sale is sometimes referred to as Auction, Foreclsoure Auction or Trustee Sale) |
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| Is there anyone else on the current deed of record? |
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| If yes, who? |
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| If yes, does this person know about the pending foreclosure? |
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| What is the total combineed monthly income in your household? |
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| How much can you currently afford on a monthly mortgage payment? |
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| Property Address: |
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| * City: |
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| * State: |
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| * Zip: |
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| What is the current value of the property? |
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| Does it need any repairs? |
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| If yes, what repairs are needed? |
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| If repairs are needed, what is the estimated cost? |
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| Is the property vacant? |
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| If yes, what is your Current address? |
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| City: |
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| State: |
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| Zip: |
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| Who is the lender on the First Mortgage? |
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| How is this lender treating you? |
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| What do you owe on the First Mortgage? |
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| What is your monthly payment on the First Mortgage? |
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| Date of the last payment made on the First Mortgage? |
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| How much will it cost you to bring the loan current? |
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| Type of loan: |
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| Only applies to you if you have a Second Mortgage |
| Who is the lender on the Second Mortgage? |
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| How is this lender treating you? |
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| What do you owe on the Second Mortgage? |
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| What is your monthly payment on the Second Mortgage? |
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| Date of the last payment made on the Second Mortgage? |
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| How much will it cost you to bring the loan current? |
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| Only applies to you if you have a ThirdMortgage |
| Who is the lender on the Third Mortgage? |
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| How is this lender treating you? |
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| What do you owe on the Third Mortgage? |
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| What is your monthly payment on the Third Mortgage? |
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| Date of the last payment made on the Third Mortgage? |
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| How much will it cost you to bring the loan current? |
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| Only applies to you if you have other liens or property taxes |
| Do you have any liens that need to be paid? |
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| If yes, please list the lien or liens and how much you owe on them: |
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| Do you have any property or IRS taxes that need to be paid? |
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| If yes, how much you owe on them: |
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| Have you filed bankruptcy? |
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| If so, what chapter of bankruptcy? |
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