Stop Foreclosure and Mortgage Assistance: First Home Counseling

Confidentiality File

Please relax and take your time and realize that you have nothing to worry about when using our service.
Fill in the blanks all the informations that apply to you and your loan. This financial information will assist us in determining the appropriated plan.

Please be advised if you do not complete your full name, your e-mail address and Loan number your application will not be send.

But if you feel more confortable you can just

this file, fill the blanks in it and FAX us to (214) 570-9728. Or you can just call and talk to one of our Conselours.

(214) 570-0669 (Dallas County)

	just the last four numbers
Loan #:*	Social Security:
Borrower:*
Mailing Address:
City, State, ZIP
E-Mail:*
Home Phone:		Cellphone:
Work Phone:		Extension:

Co-Borrower:
Mailing Address:
City, State, ZIP
E-Mail:
Home Phone:		Cellphone:
Work Phone:		Extension:

Mortgage Co. :
Phone:		Extension:

Monthly Income:

Name of Employer	Net Monthly Wage	Additional Income Description (Not Wages)	Monthly $ Amount

Monthly Expenses

Monthly $ Amount

Mortgage

Second Mortgage

Auto Payment(s)

Auto Insurance

Auto Fuel/Repairs

Credit Card Payments

Installment Loan Payments

Child Support/Alimony

Day Care/Child Care/Tuition

Food

Utilities

Condominium Association Fee

Medical (not covered by insurance)

Other Property Payments

Telephone

Cable TV

Spending Money

Other Expenses


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	2815 Valley View Lane, Suite 210 • Farmers Branch • Texas • 75234 Phone: (972) 406.1777 • Fax: (972) 406.1778 • (972) 241-0040

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