Excess Funds Claim – Homeowner Intake Questionnaire

Excess Funds Claim – Homeowner Intake Questionnaire

For potential incoming homeowners seeking to submit an excess/surplus funds claim in Georgia
Instructions: Please complete all sections. If a question does not apply, write “N/A.” Upload supporting documents where indicated. Incomplete forms may delay review.
1) Contact & Identity
Full Legal Name*

First NameMiddle NameLast Name
Other Names/Aliases (incl. maiden names)
Date of Birth*

MonthDayYear
Date
SSN (last 4 only):
Driver’s License/ID State & # (or Passport #):
Primary Phone (call/text)*
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Email*
example@example.com
Current Street Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred Communication Method*

CallTextEmail
Upload/Provide: Government ID (front & back) and proof of current address (utility bill, bank statement, lease, or USPS change-of-address)

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2) Property & Sale Details
Property Address (that was foreclosed/tax sold)*
County & Parcel/Tax ID (if known)
Type of Sale*

Mortgage foreclosureHOA/COA lien saleTax sale (county)Other
Date of Sale (if known)

MonthDayYear
Date
Name of Foreclosure Firm/Trustee/Tax Commissioner (if known)
Case/File # (if known)
Do you know the approximate amount of excess funds?*

YesNo
If yes, estimated amount: $__________
Have you contacted the trustee/court/tax office about the funds?*

YesNo
If yes, who and when?
Upload/Provide: Any sale notices, advertisements, confirmation orders, interpleader filings, or letters from the trustee/court/county

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3) Ownership & Authority
How did you hold title at the time of sale?*

Sole ownerJoint ownersLLC/CorpEstate/Heirs’ propertyTrust
Name(s) exactly as on the deed*
Acquisition method*

PurchaseInheritanceGiftDivorce decreeOther
Were you the owner of record on the date of sale?*

YesNo
If no, explain
If owner is deceased:
Name of decedent
Date of death

MonthDayYear
Date
Has an estate been opened?*

YesNoUnsure
County/State of probate
Status/Personal Representative/Administrator appointed?

YesNo
Do Letters Testamentary/Administration exist?*

YesNo
If title in a business/trust:
Entity/trust name
EIN (last 4)
Authorized signer & title
Upload operating agreement/trust docs/POA

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Upload/Provide: Most recent deed, probate Letters (if any), POA/trust/LLC authority documents

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4) Liens, Mortgages, and Claims Against Funds
At the time of sale, did any of the following exist?*

Mortgages/Deeds to Secure DebtHELOC/Second mortgageHOA/COA liens or dues owedTax liens (county/state/federal/IRS)Judgments/fi fa’s/child support liensUCC filings or mechanic’s liens
Have any creditors asserted a claim to the excess funds?*

YesNo
If yes, who and when?
Upload/Provide: Payoff letters, lien releases, judgment orders, HOA ledgers, tax payoff/estoppel, IRS notices, bankruptcy orders (if applicable)

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5) Bankruptcy / Divorce / Litigation
Have you ever filed bankruptcy?*

NeverChapter 7Chapter 13Other
Case #/District/Judge (if known)
Filing date

MonthDayYear
Date
Discharge/dismissal date

MonthDayYear
Date
Is/was the property or proceeds part of the bankruptcy estate?*

YesNoUnsure
Divorce or domestic relations orders affecting the property/funds?*

YesNo
Upload divorce decree/QDRO/property settlement.

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Any pending lawsuits/judgments involving you or the property?*

YesNo
Upload orders and explanations.

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6) Occupancy & Tenancies (historical)
Who lived at the property in the 12 months before the sale?*

OwnerTenantOther
Were there tenants?*

YesNo
If yes, provide names/leases if available.
Did you receive relocation assistance or “cash for keys”?*

YesNo
Did you remove any fixtures after sale notice?*

YesNo
explain
7) Prior Assignments, Attorneys, or Recovery Companies
Have you signed any agreement assigning your right to excess funds?*

YesNoUnsure
If yes, with whom and date
Have you previously hired an attorney or a third‑party company for this claim?*

YesNo
If yes, list firm/company & contact info
Have any claims already been filed in court or with the trustee/county?*

YesNo
Upload copies of claims or related documents.

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8) Notices You Received
Did you receive any of the following (check all that apply):

Notice of default/accelerationNotice of sale/advertisementExcess funds availability letterInterpleader/court noticeWrit of possession/evictionTax delinquency notices
Date interpleader served (paperwork received)

MonthDayYear
Date
Case number
Has an answer been filed?

YesNo
Upload copies of all notices.

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9) Supporting Documents Checklist
Government ID (required)*

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Proof of current address (required)*

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Most recent deed

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Should be Empty:

Excess Funds Claim – Homeowner Intake Questionnaire

1) Contact & Identity

2) Property & Sale Details

3) Ownership & Authority

If owner is deceased:

If title in a business/trust:

4) Liens, Mortgages, and Claims Against Funds

5) Bankruptcy / Divorce / Litigation

6) Occupancy & Tenancies (historical)

7) Prior Assignments, Attorneys, or Recovery Companies

8) Notices You Received

9) Supporting Documents Checklist