FORECLOSURE

CLIENT INFORMATION

Please answer ALL questions truthfully and completely. The information you enter in this questionnaire is confidential and protected by attorney-client privilege. The information will not be disclosed to anyone outside of this office, except in the course of rendering legal services on your behalf, or otherwise required by law.

LAST NAME

FIRST NAME

EMAIL ADDRESS

HOME PHONE #

CELL PHONE #

HOME ADDRESS

CITY

STATE

ZIP CODE

COUNTY

DATES AT CURRENT ADDRESS

PRIOR ADDRESSS (IF LESS THAN 2 YEARS AT CURRENT ADDRESS)

MAILING ADDRESS (IF NOT THE SAME AS LISTED ABOVE)

LAST FOUR OF SOCIAL SECURITY #

DRIVER'S LICENSE #

DATE OF BIRTH

STATE/COUNTRY OF BIRTH

SPOUSE LAST NAME

SPOUSE FIRST NAME

SPOUSE EMAIL ADDRESS

SPOUSE HOME PHONE #

SPOUSE CELL PHONE #

SPOUSE LAST FOUR OF SOCIAL SECURITY #

SPOUSE DRIVER'S LICENSE #

SPOUSE DATE OF BIRTH

SPOUSE STATE/COUNTRY OF BIRTH

CASE #, IF SERVED

NATURE OD CASE/REASON FOR SEEKING CONSULTATION

DO YOU OWN A HOME?

ARE YOU CURRENT ON YOUR MORTGAGE?

ARE YOU CURRENTLY LIVING IN THE HOME?

IS THE PROPERTY YOUR HOMESTEAD?

VALUE OF THE HOME $

AMOUNT OWNED ON THE HOME $

MONTHLY MORTGAGE PAYMENT $

DOES THIS MONTHLY PAYMENT INCLUDE TAXES AND INSURANCE?

DO YOU HAVE A SECOND MORTGAGE OR A HOME EQUITY LINE OF CREDIT?

IF SO, WHAT ARE THE AMOUNT(S) OF EACH $

DO YOU HAVE A HOMEOWNER'S ASSOCIATION?

ARE YOU CURRENT WITH YOUR HOA DUES?

WOULD YOU LIKE A LOAN MODIFICATION?

HAVE YOU ATTEMPTED A LOAN MODIFICATION?

WOULD YOU LIKE TO KEEP YOU HOME?

WOULD YOU LIKE A DEED IN LUE OF FORECLOSURE?

THE SPACE BELOW IS FOR ANY ADDITIONAL INFORMATION YOU BELIEVE MAY BE HELPFUL FOR US TO ASSIST YOU

HOW DID YOU HEAR ABOUT US? HOW DID YOU HEAR ABOUT US? FAMILY/FRIEND ATTORNEY REFERRAL GOOGLE OTHER SEARCH ENGINE FACEBOOK AD SOCIAL MEDIA AVVO MARTINDALE AVVO OTHER