Foreclosure Prevention Process

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1 NHS of the Fox Valley One American Way Elgin, IL (847) (847) Foreclosure Prevention Process How to OBTAIN a one-to-one consultation with a HUD-certified counselor please follow these simple steps: Read the Foreclosure Prevention Package carefully, complete all applicable forms and sign/date where indicated. It is critical that you provide the required documents listed on the checklist. Gather COPIES of all the documents for all borrowers involved with the loan. PLEASE NOTE ORIGINAL DOCUMENTS WILL NOT BE ACCEPTED AND COPIES WILL NOT BE MADE. How to SUBMIT the completed Foreclosure Prevention Package and all supporting documents either by or in person: 1. By send to foxvalleyinfo@nhschicago.org with the attached documents in PDF format only. 2. In person: To allow ample time to review and advise of any missing documentation it is essential to call our offices at x4600 during our normal business hours of Monday-Friday from 9 a.m. to 5 p.m. before arriving. Revised: 08/18/2016

2 NHS FORECLOSURE INTERVENTION INTAKE FORM Return Via: Fax The information on this form along with other required documentation will be used to advise you on available foreclosure prev ention options to either keep or transition out of your property. Please complete this form in its entirety as missing information may cause a delay in processing. Central/Wicker Park 1279 N. Milwaukee, 4th Floor, Chicago, IL North Lawndale 906 S. Homan Ave. Chicago, IL Roseland S. Michigan Ave. Chicago, IL Date: Name: SELECT PREFERRED NHS OFFICE FOR CONSULATION West Humboldt 3601 W Chicago Ave. Chicago, IL Auburn Gresham 449 W 79th St. Chicago, IL South Suburbs 1920 W 174 th St. East Hazel Crest, IL BORROWER INFORMATION 2016 Chicago Lawn 2609 W 63 rd St. Chicago, IL Fox Valley One American Way, Elgin IL Referral Source: Gender: Male Female Date of Birth: SSN (Last 4): Military Status: Veteran Active N/A Phone: Phone: Race: White Black/African American Asian Pacific Islander Other Ethnicity: Hispanic Non-Hispanic Preferred Language: Disabled: Yes No Number of People in Household: No. of Dependents: Household Type: Single Adult Married w/ Children Married w/o Children Female-Headed Single Parent Male-Headed Single Parent Two or More Unrelated Adults Other Highest Education: Junior High High-School Junior College University Name: CO-BORROWER Grad School Gender: Male Female Date of birth: SSN (Last 4): Military Status: Veteran Active N/A Phone: Phone: Race: White Black/African American Asian Pacific Islander Other Ethnicity: Hispanic Non-Hispanic Preferred Language: Disabled: Yes No Highest Education: Junior High High-School Junior College University Property Address: PROPERTY INFORMATION City: State: Zip: Grad School Primary Residence: Yes No Vacant or Condemned: Yes No Current Property Value: Property Type: Single Family Condo Multi-Family 4 units or less Multi Family 5+ units Previously Received a Modification: Yes No Previous HAMP Modification: Yes No Months Delinquent: Received Foreclosure Notice: Yes No Foreclosure Sale Scheduled: Yes No Sale Date: Reason for Delinquency: High Debt Obligations Medical Issues Inability to Sell Property Business Failure Marital Difficulties Death of Homeowner/Family Member Loss of Income Increase in Loan Payment Loss of Income Recent Bankruptcy: Yes No Bankruptcy Type: Discharge/Dismiss Date: In a court Foreclosure Mediation Program: Yes No Title/Probate Issues: Yes No Owner of Additional Properties: Yes No Quantity of Additional Properties: Neighborhood Housing Services of Chicago Intake Department 1279 N Milwaukee Ave, Chicago, IL

3 NHS FORECLOSURE INTERVENTION INTAKE FORM Return Via: Fax FIRST MORTGAGE Lender/Servicer Name: Loan No.: Mortgage Balance: Loan Origination Date: Original Loan Amount: Home Purchase Date: If Taxes and Insurance Escrowed, Amt. per Month: If Not Escrowed, Property Tax Amt. per Year: If Not Escrowed, Property Insurance Amt. per Year: Loan Type: Conventional FHA VA Insurance Company: Interest Rate: Interest Only Loan: Yes No Fixed or ARM: ARM Adjusted: Yes No SECOND MORTGAGE Lender/Servicer Name: Loan No.: Mortgage Balance: HELOC (Home Equity): Interest Rate: Fixed or ARM: MONTHLY GROSS INCOME Borrower Employer Name: Co-Borrower Employer Name: Salary/Wages: Salary/Wages: Social Security Income: Social Security Income: Retirement/Pension: Retirement/Pension: Other: Other: 2016 First Mortgage Payment: Second Mortgage Payment: Child Support/Alimony: Bankruptcy: Condo/HOA: MONTHLY EXPENSES (DO NOT INCLUDE INFORAMTION ON RENTAL PROPERTIES) Grocery: Phone/Cable/Internet: Electricity: Gas: Transportation: CREDIT CARDS AND LOANS (CAR, STUDENT, PAYDAY) Lender Name Account Type Balance Monthly payment Description LIQUID ASSETS (CHECKING ACCOUNT, SAVINGS ACCOUNT) Value ADDITIONAL INFORMATION: FOR STAFF USE Fannie Mae or Freddie Mac Owned Loan: Fannie Mae Freddie Mac Neither Notes: Neighborhood Housing Services of Chicago Intake Department 1279 N Milwaukee Ave, Chicago, IL

4 Foreclosure Mitigation Counseling Agreement and Authorization I,, hereby authorize Neighborhood Housing Services of Chicago, Inc. (NHS) to collect information regarding my financial history, credit score, demographics and any other information or data the NHS determines necessary to assist me with my delinquent mortgage. Additionally, I acknowledge and agree to the following statements related to the counseling services provided by NHS: 1. I understand that NHS provides foreclosure mitigation counseling after which I will receive a written action plan consisting of recommendations for handling my finances, possibly including referrals to other housing agencies as appropriate. 2. A counselor may answer questions and provide information, but not give legal advice. If I want legal advice, I will be referred for appropriate assistance. 3. I may be referred to other housing services offered by NHS or another agency or agencies as appropriate that may be able to assist with particular concerns that have been identified. I understand that I am not obligated to use any of the services offered to me. 4. I understand that NHS provides information and education on numerous loan products and housing programs, and I further understand that the housing counseling I receive from NHS in no way obligates me to choose any of these particular loan products or housing programs. 5. I understand that NHS receives Congressional and other funds through the National Foreclosure Mitigation Counseling (NFMC) program, HUD, the City of Chicago, NeighborWorks America and other governmental agencies and, as such, is required to share some of my personal information with NFMC, NeighborWorks America, the City of Chicago, HUD, other governmental agencies, and their program administrators or their agents for purposes of program monitoring, compliance and evaluation, and I hereby give NHS my permission to share this information with said organizations, administrators and agents. 6. I give permission for NFMC program administrators and/or their agents to follow-up with me for the purposes of program evaluation. 7. I acknowledge that I have received a copy of the NHS Privacy Policy. 8. I understand that NHS does not guarantee that services provided by NHS will (a) keep my home out of foreclosure, (b) secure from my lender/loan servicer an affordable/sustainable payment plan or work-out agreement or (c) enable me to obtain financing to either redeem my home from foreclosure or reinstate my delinquent loan. 9. I understand that by signing this agreement I will hold harmless NHS and its staff for the options NHS might offer, the advice that may be given, or for the outcome of the foreclosure mitigation counseling services provided by NHS. Client s signature Date Client s signature Date Returned signed forms to: NHS of Chicago, Attn. Intake 1279 N Milwaukee Ave Chicago, IL Revised 09/13

5 Privacy Policy Neighborhood Housing Services of Chicago, Inc. (NHS) is committed to assuring the privacy of individuals and/or families who have contacted us for assistance. We realize that the concerns you bring to us are highly personal in nature. We assure you that all information shared both orally and in writing will be managed within legal and ethical considerations. Your nonpublic personal information, such as your total debt information, income, living expenses and personal information concerning your financial circumstances, will be provided to creditors, program monitors, and others only with your authorization and signature on the Foreclosure Mitigation Counseling Agreement and Authorization. We also may use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable research information and designing future programs. We reserve the right to maintain your personal information that you have submitted either by , fax, United States Postal Service or otherwise for at least five years. Participants in the Illinois Hardest Hit Fund Program will receive this Privacy Policy notification every year during this time frame and it will be included in your file. Types of information that we gather about you Information we receive from you orally, on applications or other forms, such as your name, address, social security number, assets, and income; Information about your transactions with us, your creditors, or others, such as your account balance, payment history, parties to transactions and credit card usage; and Information we receive from a credit reporting agency, such as your credit history. You may opt-out of certain disclosures 1. You have the opportunity to opt-out of disclosures of your nonpublic personal information to third parties (such as your creditors), that is, direct us not to make those disclosures. 2. If you choose to opt-out, we will not be able to answer questions from your creditors. If at any time, you wish to change your decision with regard to your opt-out, you may call us at (773) and do so. Release of your information to third parties So long as you have not opted-out, we may disclose some or all of the information that we collect, as described above, to your creditors or third parties where we have determined that it would be helpful to you, would aid us in counseling you, or is a requirement of grant awards which make our services possible. We may also disclose any nonpublic personal information about you or former customers to anyone as permitted by law (e.g., if we are compelled by legal process). Within the organization, we restrict access to nonpublic personal information about you to those employees who need to know that information to provide services to you. We maintain physical, electronic and procedural safeguards that comply with federal regulations to guard your nonpublic personal information. Agency Relationships NHS has financial affiliation with HUD, NeighborWorks America, the State of Illinois, the City of Chicago, Illinois Housing Development Authority, Chicago Housing Authority, Freddie Mac, Fannie Mae, State Farm, the Housing Partnership Network, philanthropic foundations and financial institutions. Revised 07/15

6 NHS of the Fox Valley One American Way Elgin, IL (847) (847) Foreclosure Prevention Checklist Required Documentation NHS is a HUD-certified non-profit counseling agency that is able to help homeowners struggling to make their mortgage payments. There are many options available to prevent foreclosure and we are here to help guide you through the application process. To receive a one-to-one consultation gather copies of the following documents listed below for ALL borrower(s) on the loan. Required Documents Explanation NHS STAFF ONLY (Documents submitted) Paycheck Stubs/Profit and Loss/SSI; etc. Proof of 30 most current days; last quarter for profit and loss and most recent award letter if SSI is received Mortgage Statements Bank Statements Federal Tax Returns, W2s and/or 1099s Most recently issued within 30 days and for all mortgages on this property 2 most recent consecutive months, all pages even blank pages. For all savings/ checking accounts Submit 2 recent years of your US Federal Income Tax Returns, and W2, including all schedules * Sign and date page 1 or 2 of the Form 1040 Do not include the State Tax Return Hardship Letter Clarify the hardship, date of hardship, and if the hardship has been resolved Must be signed and dated by all borrowers Be concise and clear, can be handwritten or typed Revised: 07/11/2016 Page 1 of 1

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