Short Sale Questionnaire
PROPERTY INFORMATION
Street Address
*
City
*
State
Zip Code
*
Property Condition
*
Please Select
Excellent
Good
Fair
Needs minor repair
Needs major repair
Originally Purchased As
*
Please Select
Primary Residence
Investment
Current Occupancy Status
*
Please Select
Owner Occupied
Tenant Occupied
Vacant
Is tenant current on rent payments?
*
Yes
No
How much is monthly rent?
*
When does current lease end?
-
Month
-
Day
Year
Date
When did you move out?
-
Month
-
Day
Year
Date
Recent Upgrades to Property
Repairs Needed
Is there a Condo or Homeowner Association?
*
Yes
No
Not Sure
Are you current on your dues?
*
Yes
No
Not Sure
Estimated HOA/COA balance due
Does the property have solar panels?
*
Yes
No
When was the last payment made?
-
Month
-
Day
Year
Date
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OWNER INFORMATION
Number of owners
*
Please Select
1
2
3
Owner #1 Full Name (As appears on Mortgage)
*
On the mortgage?
*
Yes
No
Do you have security clearance?
Yes
No
Do you reside at the property?
*
Yes
No
Full Mailing Address
Phone
*
E-mail
*
example@example.com
Employment Status (please check all that apply)
*
Employed Full-Time
Employed Part-Time
Self-Employed
Retired
Unemployed
Approximate MONTHLY Gross Income (all sources above)
*
Approximate MONTHLY Net Income (all sources above)
*
Do your current liquid, non-retirement assets (checking, savings, stocks, bonds accounts, etc) exceed $10,000
*
Yes
No
Owner #2 Full Name (As appears on Mortgage)
*
On the mortgage?
*
Yes
No
Do you have security clearance?
Yes
No
Do you reside at the property?
*
Yes
No
Full Mailing Address
Phone
E-mail
example@example.com
Employment Status (please check all that apply)
*
Employed Full-Time
Employed Part-Time
Self-Employed
Retired
Unemployed
Approximate MONTHLY Gross Income (all sources)
*
Approximate MONTHLY Net Income (all sources)
*
Do your current liquid, non-retirement assets (checking, savings, stocks, bonds accounts, etc) exceed $10,000
*
Yes
No
Owner #3 Full Name (As appears on Mortgage)
On the mortgage?
Yes
No
Do you have security clearance?
Yes
No
Do you reside at the property?
Yes
No
Full Mailing Address
Phone
E-mail
example@example.com
Employment Status (please check all that apply)
Employed Full-Time
Employed Part-Time
Self-Employed
Retired
Unemployed
Approximate MONTHLY Gross Income (all sources)
Approximate MONTHLY Net Income (all sources)
Do your current liquid, non-retirement assets (checking, savings, stocks, bonds accounts, etc) exceed $10,000
Yes
No
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HARDSHIP INFORMATION
Cause of Financial Hardship (please check all that apply)
*
Unemployment
Divorce/Separation
Reduced Income
Increased Expenses
Loss of Tenant
Death In The Family
Job Relocation
Mortgage Payment Adjustment
Other
Please provide a brief statement explaining your hardship
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MORTGAGE INFORMATION
Number of Mortgages
*
Please Select
1
2
3
1st Mortgage Lender
*
Type of Loan
*
Please Select
Conventional
FHA
VA
CDA
Home Equity Line of Credit
Not Sure
MONTHLY mortgage pmt
*
When did first tenant move into the property?
-
Month
-
Day
Year
Date
Approximate Loan Balance
*
Are you current on this loan?
*
Yes
No
When was last payment made?
2nd Mortgage Lender
*
Type of Loan
*
Please Select
Conventional
FHA
VA
CDA
Home Equity Line of Credit
Not Sure
MONTHLY mortgage pmt
*
Approximate Balance
*
Are you current on this loan?
*
Yes
No
When was last payment made?
3rd Mortgage Lender
*
Type of Loan
*
Please Select
Conventional
FHA
VA
CDA
Home Equity Line of Credit
Not Sure
MONTHLY mortgage pmt
*
Approximate Balance
*
Are you current on this loan?
*
Yes
No
When was last payment made?
Did you receive Notice of Intent To Foreclose from your lender?
*
Yes
No
Not Sure
When?
-
Month
-
Day
Year
Date
Did you receive Notice of Default from your lender?
*
Yes
No
Not Sure
When?
-
Month
-
Day
Year
Date
Name of Foreclosure Attorney
Did you receive Foreclosure Auction Notice?
*
Yes
No
Not Sure
Scheduled Auction Date
-
Month
-
Day
Year
Date
Name of Auctioneer
Have you filed for Bankruptcy in last 2 years?
*
Yes
No
Type
*
Chapter 7
Chapter 13
Not Sure
Date Filed
-
Month
-
Day
Year
Date
Was it discharged?
*
Yes
No
Not Sure
Date discharged
-
Month
-
Day
Year
Date
Are you considering filing for Bankruptcy
*
Yes
No
Not Sure
Submit
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