Mortgage Modification Prequalification

Homeowner Full Name:
Co-Owner Full Name:
Email Address:
Primary Phone:
Mailing Address:
Property Address (If different from mailing address)
Current Mortgage Company Name, address, phone:
Loan number:
Original Loan Amount:
Loan Origination Date
Original Amortization Term:	15 Yr 20 Yr 30 Yr 40 Yr 50 Yr
Interest % Rate:
Loan Type:	FHA VA Conventional Fannie Mae/Freddie Mac
Loan Terms:	Fixed 2/28 3/27 5/1 Arm HELOC Stand Alone 2nd Purchase Money
Check all that apply:	Balloon Pre-Payment Penalty Interest Only Negative Amortization
Loan Balance Due:
Months past due (if any):
Current Payment:
Are you currently involved in or had prior: (check all that apply)	Bankruptcy Loan Modification Re-Payment Plan Forebearance Plan Short Sale Negotiation
Do you have a second mortgage?	Yes No
Describe 2nd Mortgage terms, payment amount, number overdue, company name, address and phone, loan number and amount:
Monthly Income (Net):
Please list your monthly debt including the following: HOA Dues Alimony/Child Support Auto loan payment(s) Auto insurance Auto Expenses: Gas/Maintenance/Parking Utilities: Gas/Electric/Water Cable/Internet/Phone Cell Phone Food/Toiletries Health Insurance Life Insurance Student Loans Credit card debt Installment loan debt Other (explain) Include minimum payments and balances.
Total Estimated Monthly Debt:
Estimated value of the home:
Is your home in foreclosure? If so, when was the foreclosure filed and what is your sale date?
Do you occupy this home?	Yes No
List assets: (Investment homes, vehicles,retirement plans, checking and savings/money market accounts, stocks/bonds/cd's, etc.)
Please give us a full description of your hardship situation so we may create a hardship letter on your behalf to be used in your negotiation. Please include all dates and details.
Please upload copy of your most recent mortgage statement.
Please upload a copy of your second mortgage statement.
Please upload last two years tax returns.
Please upload two most recent bank statements.
Please upload all supporting documentation: Example: Divorce Decree, Medical reports, letters of dismissal, etc.
If you are unable to upload your documents you may fax them to 720-836-4275 or mail/deliver them to 2420 W 26th Ave Ste 300D Denver CO 80211.
I will fax, mail, or deliver my mortgage statements, bank statements, tax returns, and supporting documents in lieu of uploading to this form.	Yes No
Please list all other property addresses with mortgage company information that you would like to modify:
Homeowner social security number
Co-owner social security number
I authorize AWS and AWS Affiliates to full access to my mortgage information and authorize communication with my mortgage company(s) for the purpose of Mortgage Modification. I have read and understand my rights under the Home Affordable Program. I understand there are no guarantees and have not been promised specific term results of this modification process.	I Agree I Disagree

AWS Team at Keller Williams
AWS
Office: 303-561-2405
Direct: 303-561-2405
Cell: 720-933-4009
Fax: 720-836-4275
2420 W 26th Ave Ste 300D
Denver, CO 80211

© 2000-2009 Hillside Technology, Inc. All Rights Reserved. Data on this web site is deemed reliable but is not guaranteed.	Agent Login Privacy Policy - Terms of Use HomeCards Support
HomeCards - Real Estate Websites for Agents and Brokers Real Estate Software, Websites and Leads

Please Login or Signup for Free

New to the site? Create a New Account


Name: *
Email: *
Confirm Email: *
» Valid Email Required - Privacy Guaranteed Your email address will NEVER be sold to any 3rd parties.

Choose a Password: *

Existing user? Please Login

Email:
Password:

Required Information

Welcome back, we have noticed you've been very active on the system and would like to offer you our personal assistance. Would you like to see any of the homes you've researched? We are happy to arrange a time that fits your schedule so you can visit homes you're interested in with one of our Client Specialists. Please give us a call. In the meantime, please continue using YOUR Private MLS to search for homes.

Please enter your phone #: