Client Assistance Application MORTGAGE

MORTGAGE ASSISTANCE APPLICATION

Please complete all information and upload documents before submitting.
FIRST NAME*
LAST NAME*
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMAIL
example@example.com
PHONE NUMBER*
Please enter a valid phone number.
ARE YOU A US VETERAN?*

YESNO
IF YES, IN WHICH BRANCH DID YOU SERVE?

AIR FORCEARMYCOAST GUARDMARINESNAVY
PLEASE EXPLAIN WHY YOU ARE REQUESTING MORTGAGE ASSISTANCE.*
PLEASE COMPLETE ONLY ONE SECTION BELOW.
- SECTION ONE IS TO BE COMPLETED IF YOU HAVE NOT RECEIVED AN INCOME IN THE LAST 30 DAYS.
- SECTION TWO IS TO BE COMPLETED IF YOU HAVE RECEIVED AN INCOME IN THE LAST 30 DAYS.
Self-Attestation for No Income in the Last 30 Days

SECTION ONE - COMPLETE IF YOU HAVE RECEIVED NO INCOME IN THE LAST 30 DAYS.
Iname certify that I have not been employed or self-employed (receiving earned income), completed any odd jobs, or had any other source of income (SSA/SSDI/SSI, child support, alimony, retirement income, etc.) in the last 30 days.

I attest that this statement about myself, to determine eligibility, is true and correct to the best of my knowledge.

Signature
IF YOU HAVE NO INCOME, PLEASE BE SURE YOU HAVE COMPLETED THE ATTESTATION OF NO INCOME PORTION OF THIS APPLICATION ABOVE.
Self-Attestation for Income in the Last 30 Days

SECTION TWO - COMPLETE IF YOU HAVE RECEIVED AN INCOME IN THE LAST 30 DAYS.
I have received this gross amount of income $ amountondate from business . Please provide documents to verify this information (pay stubs, etc.)
I attest that this statement about myself, to determine eligibility, is true and correct to the best of my knowledge.

Signature
PROOF OF INCOME FOR THE PAST 30 DAYS (PAYSTUBS, SSDI, ETC.)

Cancelof

MORTGAGE ASSISTANCE APPLICATION

Self-Attestation for No Income in the Last 30 Days

Self-Attestation for Income in the Last 30 Days