Intake Form

Our free no obligation initial evaluation will help you be more prepared and  informed regarding the following issues:

• Deed in lieu of foreclosure options
• Short Sale qualification evaluation
• Possible recourse your lender may have against you on a short sale or foreclosure
• Possible tax Consequences
• Free property evaluation
• Preparation of estimated HUD 1 Statement

To assist us in providing you with the most effective and efficient evaluation, please complete the  intake form as thoroughly as possible.  A counselor will review your information and will contact you shorty to discuss your options.

Your Privacy is important to us.

Alternatives To Foreclosure Intake Form

First Name *
Last Name *
Phone *
Email *
Address *
City *
State/Region *
Zip/Postal Code *
Is this your primary residence? *	YES NO
Explanation of Financial Hardship:
Months Behind: *
Original Purchase Price: *
Year Purchased *
1st Mortgage Servicer/Bank *
Payoff or Balance on 1st Loan
2nd Mortgage Servicer/Bank
Payoff or Balance on 2nd Loan
Payoff or Balance on other loans
Has a notice of default/trustee sale been posted? *	YES NO
Today’s Approximate Market Value
Have you ever refinanced to cash out? *	YES NO UNSURE
Amount of cash out refinance
Any of these loans a Home Equity Line of Credit? *	YES NO UNSURE
Amount of Home Equity Line of Credit
Were any of the funds used to improve property? *	YES NO
Amount of total improvements
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