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Foreclosure Counseling Intake

Foreclosure Prevention Intake Form

Step 1 of 9

11%

I. Personal Information Borrower

first person listed on the loan
Title
Name
Address
MM slash DD slash YYYY
Race
Gender
Disabled
Veteran
Education
MM slash DD slash YYYY
MM slash DD slash YYYY
PLEASE UPLOAD A SEPARATE DESCRIPTION AND SOURCE OF ANY OTHER INCOME
Max. file size: 50 MB.
Household Type

II. Personal Information Co-Borrower

second person listed on the loan
Title
Name
MM slash DD slash YYYY
Race
Gender
Disabled
Veteran
Education
MM slash DD slash YYYY
MM slash DD slash YYYY
PLEASE UPLOAD A SEPARATE DESCRIPTION AND SOURCE OF ANY OTHER INCOME
Max. file size: 50 MB.

III. HOUSEHOLD FINANCIAL INFORMATION

(your total household income each year before taxes)
(your total household expenses each year)
(including mortgages, credit cards, loans, etc.)

IV. MORTGAGE LOAN INFORMATION

PROPERTY IS A:
DO YOU WANT TO KEEP YOUR HOME?
amount before delinquency
DOES THIS INCLUDE TAXES & INSURANCE?
HAVE YOU EVER REFINANCED?
month/year
IS YOUR LOAN: (refer to your loan documents)
FIXED?
ARM?
INTEREST ONLY?
HYBRID ARM?
OPTION ARM?
VA or FHA INSURED?
MM slash DD slash YYYY
IS THERE A SECOND MORTGAGE ON THE PROPERTY?
Loan Type
MM slash DD slash YYYY

V. DEFAULT / DELINQUENCY INFORMATION

FIRST MORTGAGE:
month & year
without delinquency
as of today
month & year
what is the amount your lender is asking you to pay?
FIRST MORTGAGE:
month & year
without delinquency
as of today
month & year
what is the amount your lender is asking you to pay?
ARE YOUR PROPERTY TAXES ALSO IN DEFAULT?
HAVE YOU (OR WILL YOU) FILE FOR BANKRUPTCY?
ARE YOU DISCUSSING YOUR SITUATION WITH AN ATTORNEY?
DO YOU HAVE HOMEOWNERS INSURANCE?
Previous Delinquencies?
Previous Workouts?
Have you received other assistance?
Talked to Mortgage Company?
Is Loan Modification in progress?
Own Home as Primary Residence?
Property In Bankruptcy?
Is this situation caused by a:
List all creditors and amounts owed.

VI. CONSENT

I (We) acknowledge that a copy of this form is as valid as the original. By signing below, I (we) hereby certify that the above information is true and correct to the best of my (our) knowledge and belief.
Reset signature Signature locked. Reset to sign again
MM slash DD slash YYYY
Reset signature Signature locked. Reset to sign again
MM slash DD slash YYYY

Step 1: Make an Appointment

Call 307-233-8511 to set up an initial appointment.

Step 2: Complete Intake Process

You can complete it using the link below or request hard copy forms to be sent to you by calling 307-233-8511.

Fillable Form Here

Step 3: Submit Required Documentation

After you have submitted the required information from Step Number 2 you will need to gather the following information and submit it as soon as possible:

You can submit these by:

  1. Mailing Hard Copies to
    Attn. Foreclosure Prevention Services
    2345 E 2 nd Street
    Casper, WY 82601
  2. scan and send them to foreclosurehelp@whninc.org
  3. Upload them here

You will need:
One COPY of:

  • Last monthly mortgage statement and last notice from lender(s)
  • Last 2 years tax returns MUST BE SIGNED AND DATED
  • Last 2 months proof of all household income (paystubs, unemployment, Social Security, disability, child support, etc.)
  • Last 2 bank statements (all pages) for all asset accounts (checking, savings, 401K, etc.)
  • List of monthly expenses (in addition to the budget)
  • Proof of occupancy (a recent utility bill in your name at the property address, include all pages of the bill)
  • Write a foreclosure hardship letter stating the circumstances that lead to the financial crisis. Must be signed and dated by the borrower and co-borrower.

If self-employed, also include one COPY of the following:

  • Last 6 months bank statements for business
  • Last 2 years business tax returns MUST BE SIGNED AND DATED (if filed separately from personal)
  • Year-to-date Profit & Loss statement

Contact Us

For more information about Foreclosure Counseling, please contact

Beth Skidmore

foreclosurehelp@whninc.org
307.233.8511
877.549.1402
fax: 307.472.0893

What people are saying about Foreclosure Counseling

“I honestly don’t know if I would have been able to pull it off at the end without you! Actually I know I wouldn’t have! “

“You have no idea how much all your help and going the extra mile for us means to me!”

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