FORECLOSURE INTERVENTION COUNSELING APPLICATION

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2707 Main Street ● Sayreville, NJ 08872 Tel: (732) 727-9500 – www.ffcdc.net REV. CLARENCE BULLUCK, EXECUTIVE DIRECTOR/VP

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FORECLOSURE INTERVENTION COUNSELING APPLICATION 

Dear Homeowner:

We understand you may be experiencing financial problems that could possibly result in the loss of your home through foreclosure. We also understand that sometimes financial problems are due to circumstances beyond our control. We are here to help you by working with you and your Mortgage Servicer to find a solution that will help you stay in your home. Faith Fellowship Community Development Corporation (FFCDC) is approved by the U.S. Department of Housing and Urban Development (HUD). We provide free foreclosure prevention and loss mitigation counseling services to homeowners who may be struggling to make their mortgage payments.

Our Certified Counselors are experienced in foreclosure prevention counseling and will work diligently with you to help you cure your mortgage delinquency. You are only (3) three steps away from getting the help you need.

1. Begin the process by immediately completing and returning the Service Application and the documents listed below. Please be advised that we are unable to process incomplete Applications so do your best to complete the Application in its entirety. You may type your Responses directly in the Application Form and sign it when you are done.

2. Upon receipt of your Application, a Counselor will contact you to schedule a face-to-face Appointment. During the Appointment, the Counselor will assess your current mortgage status, perform an in-depth financial analysis and customize a Work Plan geared towards resolving your delinquency. In addition, the Counselor will review any current Federal, State and Local programs offering financial assistance to delinquent homeowners and will explain your eligibility qualifications for any such program.

3. The Counselor will then contact your Mortgage Servicer to discuss viable workout options, as well as provide assistance in preparing and assembling specific documents required by your Mortgage Servicer. The Counselor will upload/forward the documents using the Mortgage Servicer’s private and secure portal where they will be reviewed and assessed for the best possible resolution.

So please don’t delay; time is of the essence. Below are the documents you will need to provide:  Pay stubs of the most recent two-month period for all borrowers on the mortgage;  Proof of income (i.e., unemployment, social security, etc.);

 Most recent two months bank statements;

 Current mortgage statement from your mortgage company;  Current utility bills;

 Most recently filed Federal Tax Return and W2s;

 Delinquency letter and documents received from your mortgage company’s attorneys and Sheriff Sale Notifications (if applicable); and

 A hardship letter explaining the situation that caused you to fall behind in your mortgage payments. The Application and documents should be mailed or dropped off at:

Faith Fellowship Community Development Corporation 2707 Main Street Sayreville, New Jersey 08872 Attention: Lucy Bulluck  732-727-9500 Ext. 1171

Faith Fellowship Community Development Corporation provides counseling in both English and Spanish. You may bring a trusted confidante or family member to facilitate translations we do not provide. Our facility is handicapped accessible with a wheelchair ramp.

Thank you for your interest in our Agency and we look forward to working with you. Sincerely,

Reverend Clarence Bulluck – Executive Director / VP

PLEASE DO NOT SEND ORIGINAL DOCUMENTS.

YOU MAY TYPE YOUR RESPONSES DIRECTLY IN THE APPLICATION FORM. DO NOT E-MAIL IT BACK TO US.

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2707 Main Street ● Sayreville, NJ 0887 Telephone: (732) 727-9500, EXT. 1701 REV. 4.6.2016 

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FORECLOSURE INTERVENTION COUNSELING APPLICATION 

DATE OF APPLICATION: DATE RECEIVED:

RECEIVED OTHER SERVICES WITH OUR AGENCY?:

□

Yes

□

No RECEIVED BY:: ________ Mail ______Drop-off

SERVICES YOU RECEIVED:__________________________________ COUNSELOR::

APPLICANT CONTACT

FIRST NAME: ________________________________________

LAST NAME: ________________________________________

STREET ADDRESS:____________________________________

CITY:_______________ STATE:_____ ZIP CODE:__________

CELL PHONE:________________________________________

MIDDLE: _________ SUFFIX: JR.___ SR.____ III____ IV___

E-MAIL:_____________________________________________

PREFERRED LANGUAGE: ENGLISH_______ SPANISH________

HOME #:________________ WORK #:_____________________

SPONSOR: ______________________________ PURPOSE: N/A

CASE DATA

SERVICE TYPE: MORT.DEFAULT/EARLY DELINQ.HUD ACTIVITY TOTAL #CO-APPLICANTS: (Include Spouse): None ____ 1____

HOW DID YOU HEAR ABOUT US? Agency(Website)___ Lender__

ADDITIONAL FIELDS FUNDING SOURCES: (FOR OFFICE ONLY)

SELECT CORRECT NOFA COMPREHENSIVE (FOR OFFICE ONLY)

2_____ 3_____ 4_____ 5_____

Church Member___ Realtor___ Walk-in____ Word/Mouth____

CASE (COUNSELING)TERM: Short ___ Mid ___ Long ____

DEMOGRAPHICS:

RACE:Black or African Amer.____White____ Native Hawaiian/Other Pacific Islander___ Amer. Indian/Alaskan Native & Black ____

Hispanic___ Asian___ Asian and White___ American Indian/Alaskan Native____ American Indian/Alaskan Native & White____

Black/African American & White____ Choose Not to Respond______ Other: __________________________________________

HISPANIC?: Hispanic____ Not Hispanic ____

VETERAN?: Yes_____ No ______

HEAD OF HOUSEHOLD?: Yes_____ No ______

ETHNICITY: Mexican_____ Puerto Rican ____

FOREIGN BORN? Yes_____ No _______

DISABLED? Yes_____ No ______

#IN HOUSEHOLD: 1___ 2___3___4___ ___ GENDER: Male ___ Female_____

RURAL STATUS : Does Not Live in Rural Area_____ Lives in Rural Area _______

ENGLISH PROFICIENCY?: Is English Proficient____ Is Not English Proficient _____

AGE:____________ BIRTHDATE: (mm/dd/yyyy) ____________________________

MARITAL STATUS: Married____ Single____ Chose Not to Respond______

DO YOU HAVE ADISABLED DEPENDENT? Yes_____ No ______

_

EDUCATION: College __ Jr. College___ Graduate School___

FIRST TIME HOMEBUYER? Yes______ No ______

Vocational___ High School/GED___ Jr. High ___ Other ____

ACTIVE MILITARY? Yes_______ No ______

FINANCIAL INFORMATION:

HOUSEHOLD ANNUAL (GROSS)INCOME: $__________________

COUNTY OF RESIDENCE ( I.E.,MIDDLESEX): ____________________

CURRENT RESIDENCE: Own ___ Rent ___ YRS.___ MOS.____

 ADDITIONAL FIELDS SOC.SEC. #: _______________________

FIRST GENERATION HOMEBUYER? Yes________ No ________

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APPLICANT INCOME / EMPLOYMENT

EMPLOYER: ____________________________________________

YEARS IN PROFESSION: ___________________________________

TITLE*: _______________________________________________

MONTHLY GROSS INCOME* (before taxes) $_____________________ EMPLOYER ADDRESS: ____________________________________

STATE: _________________ ZIP CODE: _____________________

OTHER SOURCE OF MONTHLY INCOME: $_____________________

Alimony _____ ___Child Support ___Bonuses Dividends/Interest ___Overtime ___Welfare

DATE START (mm/dd/yyyy):* ____________________________

SELF EMPLOYED? Yes_____________ No ______________

TYPE OF BUSINESS*: ___________________________________

MONTHLY NET INCOME* (after taxes) $_______________________ CITY: _______________________________________________ TELEPHONE: _________________________________________

(CHECK OTHER SOURCE OF MONTHLY INCOME BELOW)

___Commissions ___Disability/SSI ___Welfare

___Unemployment ___Rent ___Retirement/SSI

CO-APPLICANT

FIRST NAME: _________________________________________ LAST NAME: __________________________________________ STREET ADDRESS:_____________________________________ CELL PHONE:_________________________________________ HOME #:________________ WORK #:_____________________

RELATION TO APPLICANT: Wife____ Husband___ Mother_____

MIDDLE: _____ SUFFIX: JR.___ SR.____ II____ III___

E-MAIL:____________________________________________

CITY:_______________ STATE:_____ ZIP CODE:__________

PREFERRED LANGUAGE: ENGLISH_______ SPANISH________ SOCIAL SECURITY #: __________________________________

MONTHLY GROSS INCOME:$____________________________

Father___ Brother ___ Sister ___ Friend ___ Other______

DEMOGRAPHICS:

RACE:Black or African Amer.____White____ Native Hawaiian/Other Pacific Islander___ Amer. Indian/Alaskan Native & Black ____

Hispanic___ Asian___ Asian and White___ American Indian/Alaskan Native____ American Indian/Alaskan Native & White____

Black/African American & White____ Choose Not to Respond______ Other: __________________________________________

IS HISPANIC: Hispanic___ Not Hispanic ___

VETERAN?: Yes_______ No _______

FOREIGN BORN? Yes_____ No ______ DISABLED? Yes_______ No ______

GENDER: Male ___Female_____ BIRTHDATE: (mm/dd/yyyy) __________________

CO-APPLICANT INCOME / EMPLOYMENT

EMPLOYER: ____________________________________________

YEARS IN PROFESSION: ___________________________________

TITLE: ________________________________________________

MONTHLY GROSS INCOME* (before taxes) $_____________________ EMPLOYER ADDRESS: ____________________________________

STATE: _________________ ZIP CODE: _____________________

OTHER SOURCE OF MONTHLY INCOME: $______________________

Alimony _____ ___Child Support ___Bonuses Dividends/Interest ___Overtime ___Welfare

DATE START (mm/dd/yyyy):______________________________

SELF EMPLOYED? Yes_____________ No ______________

TYPE OF BUSINESS: ____________________________________

MONTHLY NET INCOME* (after taxes) $_______________________ CITY: _______________________________________________

TELEPHONE: _________________________________________

(CHECK OTHER SOURCE OF MONTHLY INCOME BELOW)

___Commissions ___Disability/SSI ___Welfare

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3 MONTHLY BUDGET

EXPENSES PAYMENT EXPENSES PAYMENT

~Auto

_~~

~Savings

_~~

Auto Insurance Other Savings

Auto Loan ~Tax

~~

Auto Repairs / Maintenance ~Utilities

~~

Gasoline Internet

Parking / Tolls Cable TV

~Charity

~~

Cell Phone

Church Tithing Electricity

~Child Support/Alimony

~~

Trash Services

Daycare Heating (Nat Gas or Oil)

~Credit Card Min Payments

_~~

Water/Sewer

Credit Card Min Total Telephone

~Credit Collections

~~

Internet/Phone/Cable Bundle

IRS or other Taxes DISCRETIONARY

Judgment ~Charity

~~

~Education

~~

Church Donations

School Lunches Other Gift/Donation

Tuition ~Child Support/Alimony

~~

Books / school supplies Children Tuition

~Entertainment

~~

Child School Activities/Lunch

Athletic Events/Hobbies ~Dining

_~~

~Housing Payment

~~

~Education

~~

1st Mortgage School Fees/Books/Supplies

2nd Mortgage ~Entertainment

~~

Home Owners Assoc. Movies / Tickets

Home Equity Line ~Food and Groceries

~~

Homeowners/Renters Insurance Food at Work

Property Tax Groceries

Rent ~Gifts

~~

~Installment Loans

~~

Birthday Gifts

Installment loan ~Household

~~

Student Loan Personal Items/Toiletries

~Insurance

_~~

Barber/Beauty Shop

Health Insurance Clothing

Life Insurance

~~

Laundry/Cleaning

~Medical Fitness Membership

Dentist Tobacco

Doctor Visit / Co~pay Alcoholic Beverages

Vision / Glasses / Contacts ~Miscellaneous:

~~

Medical Bills

Medications ~Pet Expense

~~

~Miscellaneous

~~

Pet Supplies

Other Description ~Public Transportation

_~~

Bus or Train

Rental Property (Expenses)

SUBTOTAL SUBTOTAL

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GPS - FORECLOSURE MITIGATION DATA AND WORK PLAN

INTAKE:

Head of Household: Household Type*

□ Female headed single-parent household □ Male headed single-parent household □ Married with children

□ Married without children

◄continued ►

□ Single adult

□ Two or more unrelated adults □ Other

Default Reason*

□ Business Venture Failed □ Divorce/Separation □ Increase in Expenses □ Increase in Loan Payment □ Loss of Income

◄continued ►

□ Medical Issues

□ Poor Budget Management Skills □ Death of Family Member □ Reduction in Income □ Other

Age*

AUTHORIZATION:

Signature Required* Reviewed The Privacy Policy _{& Signed the Authorization? □ Yes □ No}

PROPERTY:

Property Type* □ Single Family □ Co-Op _{□ Townhouse/Condo □ Multi 2-4 Units}

Street Address* Zip Code*

City* Census Tract N/A

MSA (County)* State

Market Value $ FEMA Relief Type N/A

LIENS & PAYMENTS

Lien Holder Name*

(Mortgage Company)

Payment Status

(at contact)* □ Current □ 30 - 60 days late □ 61-90 days □ 91-120 days □ 120+ days Lien Holder Type* □ Association □ Bank □ Credit Union _{□ Mortgage Lender □ Other} Payment Type* □ Assoc. Dues □ Insurance □ Prop Taxes _{□ Mortgage-Fixed □ Mortgage–ARM}

Current (Mortgage)

Servicer* Servicer Loan #

Income Doc Type*

□ Full Document Provided

□ NINA (no income no asset verified) □ Not Available □ Reduced Document □ SISA (stated income stated assets)

Term Type

(Mortgage)* □ 15 Year □ 30 Year □ Other

Monthly Payment $ Current Interest _{Rate (%)}

Past Due Amount (including late and

other fees* $

Current Principal Balance $ Term (# of months

remaining in Mortgage)

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IDENTIFYING POSSIBLE LOAN SCAMS

WE ARE REQUIRED BY THE DEPARTMENT OF HOUSING & URBAN DEVELOPMENT (HUD) TO ASK THE FOLLOWING QUESTIONS IN ORDER TO HELP IDENTIFY POSSIBLE LOAN SCAMS:

1. Did anyone offer to help modify your mortgage, either directly, through advertising, or by any other means such as a flyer? □ Yes □ No 2. Were you guaranteed a loan modification or asked to do any of the following: pay a fee, sign a contract, redirect

mortgage payments, sign over title to your property, or stop making loan payments? □ Yes □ No

MAKING HOME AFFORDABLE ELIGIBILITY DETERMINATION

Is the amount you owe on your 1st_mortgage

equal to or less than $729,750? □ Yes □ No Are you having trouble paying your mortgage? □ Yes □ No

Did you get your current mortgage before January 1, 2009? □ Yes □ No

Is your payment on your 1st_{mortgage (including}

principal, interest, taxes, insurance and homeowner association dues, if applicable) more than 31% per your current gross income? □ Yes □ No

Is your home your primary residence? □ Yes □ No Is the property located in New Jersey? □ Yes □ No Do you currently reside in the home? □ Yes □ No Was the property your primary residence for the past year? □ Yes □ No Do you want to retain ownership of the property? □ Yes □ No Have you listed the property for sale?

Do you have Listing Agt? □ Yes □ No □ Yes □ No Do you own other property? Is that property in

foreclosure? □ Yes □ No □ Yes □ No Are you involved in or have initiated bankruptcy

proceedings? □ Yes □ No

All of the information we have provided is correct and factual. No information has been withheld. We understand the

necessity for accurate and complete information. We will provide any additional information needed to complete this

Service Application. We understand that deliberately providing inaccurate information or an unwillingness to timely

provide the Counselor with the necessary information or documents to assist us will result in closing our file and no

further assistance from the FFCDC will be provided.

Applicant’s Signature

Date

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2707 Main Street ● Sayreville, New Jersey 08872 Telephone: (732) 727-9500

AUTHORIZATION TO RELEASE INFORMATION

I (We) hereby authorize Faith Fellowship Community Development Corporation (FFCDC) to release/ exchange information from my records in order to assist me in resolving a mortgage default.

This information will be released only to those that our organization believes can provide assistance in resolving a mortgage default. This information release/exchange will be restricted to specific financial data, such as income, budget, debt and mortgage details provided by you.

CREDIT REPORT AUTHORIZATION

I (We) hereby give permission to pull my (our) credit report for the purposes of my (our) application for assistance in regards to our mortgage delinquency to FFCDC.

All information will be kept confidential between my Counselor and me. I further understand that Faith Fellowship Community Development Corporation will be held harmless for information received in this Credit Report.

REQUESTED INFO

APPLICANT

CO-APPLICANT

First Name:

Middle Name:

Last Name:

Suffix:

□ Jr. □ Sr. □ II □ III □ ____ □ Jr. □ Sr. □ II □ III □ ______

(m/d/yyyy) Date of Birth:

Social Security #:

Address:

City:

State:

Zip Code:

BOTH SIGNATURES ARE REQUIRED FOR A JOINT REPORT.

Applicant

Date

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Authorization to Loan Servicer for Release of Information Date: _______________________

TEL #:

TO: NAME/ADDRESS OF MORTGAGE COMPANY/SERVICER:

Attention: Loss Mitigation Department

Re: Loan/Account #: Borrower(s): Property Address: Dear Sir or Madam:

We are working with Faith Fellowship Community Development Corporation (“FFCDC”), a HUD-approved housing

counseling agency on a plan to resolve our mortgage delinquency and to address our financial issues. We hereby authorize you to release any and all information concerning our account to FFCDC at their request.

We further authorize you to discuss our case with the FFCDC Counselor(s) listed below.

Tel.

Fax

Counselor’s Name

Tel.

Fax

Counselor’s Name

We hereby acknowledge that this consent is voluntary. We further acknowledge that we may revoke this consent at any time except to the extent that action based on this consent has been taken. You may release additional information to this agency in the future without further authorization. We acknowledge that a copy of this form is as valid as the original. This consent shall be valid for one (1) calendar year from the date below.

Applicant’s Signature

Date

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Foreclosure Mitigation Counseling Agreement

(Authorization)

I understand that FAITH FELLOWSHIP COMMUNITY DEVELOPMENT CORPORATION (FFCDC) 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.

I understand that FFCDC receives Congressional funds through the National Foreclosure Mitigation Counseling (NFMC) program and, as such, is required to share some of my personal information with NFMC program administrators or their agents for purposes of program monitoring, compliance and evaluation.

I give permission for NFMC program administrators and/or their agents to follow-up with me for the purposes of program evaluation.

I acknowledge that I have received a copy of FFCDC’s Foreclosure Mitigation Counseling Privacy Policy.

I may be referred to other housing services of the organization 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.

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.

I understand that FFCDC provides information and education on numerous loan products and housing programs and I further understand that the housing counseling I receive from FFCDC in no way obligates me to choose any of these particular loan products or housing programs. □ Please check here if you do not want to be contacted by NFMC for program evaluation purposes.

Applicant’s Name

Applicant’s Signature

Date

Co-Applicant’s Name

Co-Applicant’s Signature

Date

The undersigned verifies that the client was fully informed of the information contained herein and understood its nature.

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Foreclosure Mitigation Counseling Privacy Policy

We are committed to ensuring 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 the limitations of law. Your “nonpublic 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. We may also use anonymous aggregated case file information for the purpose of evaluating our services, gathering valuable research information and designing future programs.

Other Private Data

Under New Jersey, your name and address are public data. All other data we may ask about you is private data on individuals. Except for your social security number, providing and agreeing to share your private data is mandatory for participation in the Foreclosure Mitigation Counseling Program under the terms of the federal grant from NeighborWorks that funds the program. If you do not agree to allow us to share the data with the entities identified below, we will not be able to provide foreclosure mitigation counseling.

We will share the data only with the following entities or their representatives for the purposes of program management, compliance monitoring, and program evaluation:

● Staff of our Agency that need it to work on your case;

● NeighborWorks America, the entity mandated by Congress to account for how the program funds are used and determine the program’s effectiveness, or its authorized representatives;

● New Jersey Home Mortgage Finance Agency (NJHMFA), the recipient of the grant for this program; ● Department of Housing & Urban Development (HUD);

● Any other entity properly authorized under law to view your data.

If you agree to allow us to collect and share information as described above, please indicate your approval with your signature, below.

Applicant’s Name

Applicant’s Signature

Date

Co-Applicant’s Name

Co-Applicant’s Signature

Date

Sharing Data with Creditors

Sharing some of your personal financial information with creditors may be necessary to effectively help you resolve your financial difficulties. If you agree that we may share private data, such as information on your total debt, income, living expenses and personal information concerning your financial circumstances with your creditors, program managers, and staff working on your case, please indicate your approval by signing below.

Applicant’s Name

Applicant’s Signature

Date

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Foreclosure Mitigation Counseling Disclosure Statement

Faith Fellowship Community Development Corporation (FFCDC) is required to fully disclose potential and actual conflicts of interest so that clients are in a position to make fully informed decisions.

FFCDC certifies that its staff who provide foreclosure intervention counseling under the NFMC and other grants have no conflict(s) of interest due to any other relationship with servicers, real estate agencies, mortgage lenders and/or other industry partners (whether identified or not) that may stand to benefit from particular counseling outcomes.

FFCDC provides comprehensive housing counseling services including, but not limited to, pre- and post-purchase homeownership, credit/budgeting, and mortgage delinquency and foreclosure prevention.

TYPES OF SERVICES PROVIDED:

● Homeownership Counseling: FFCDC provides Homeownership Workshops and free one-on-one home ownership counseling to first time

homebuyers who are interested in knowing the facts about buying a home and about low interest rate loan programs.

● Credit/Budget Counseling: FFCDC provides Credit/Budget Workshops and free one-on-one counseling. The counselor helps to analyze the

financial and credit situation, identify barriers to affordable mortgage financing and other housing problems and develop a plan to remove barriers. The counselor also provides assistance in debt management by helping to prepare a monthly, manageable budget and spending plan which will enable the client to resolve his/her personal financial challenges.

● Foreclosure Prevention Counseling: FFCDC provides free Foreclosure Prevention Workshops and free foreclosure counseling to families who are

in danger of losing their homes because of a default or potential default on their mortgage payments. Assistance is provided with the following mitigation options: loan forbearance, loan modification, partial claim, pre-foreclosure sale, and deed-in-lieu of foreclosure.

SOME OF OUR PARTNERS

Brand New Day, Bank of America, Borough of Woodbridge, NJ Department of Banking & Insurance, NJ Housing & Mortgage Finance Agency, NJ Citizen Action, City of Perth Amboy, Hong Kong Savings Bank (HSBC), Freddie Mac, NJ Administrative Office of the Courts, NJ Housing Network, PNC Bank, FDIC, Fannie Mae, Puerto Rican Association for Human Development of Perth Amboy, Faith Fellowship Ministries World Outreach , Center, Department of Housing & Urban Development (HUD), Rutgers University-NJ Small Business Development Centers, Info-line of Middlesex County, Magyar Bank, State of New Jersey, Attorney General’s Office, MetLife Bank, Middlesex County Housing and Community Development (ADDI Program), NeighborWorks®America, NJ Department of State, Office of Faith-Based Initiatives (OFBI), Sovereign Bank, TD Bank, Township of Sayreville, Wells Fargo, William Paterson University.

ALTERNATIVE SERVICES AND PROGRAMS

● New Jersey Foreclosure Mediation Program makes housing counselors, lawyers, and mediators available to homeowners facing foreclosure.

● HOPE NOW: An alliance between counselors, mortgage companies, investors, and other mortgage market participants. This alliance will maximize

outreach efforts to homeowners in distress to help them stay in their homes and will create a unified, coordinated plan to reach and help as many homeowners as possible.

FFCDC does not have the authority to deny or approve any foreclosure prevention workout or dispute resolution.

You have the right to make the final decision regarding your housing needs and to seek additional opinions regarding your options regardless of any recommendations of FFCDC, its affiliates or partnerships.

You are not obligated to receive or utilize any services offered by FFCDC, its affiliates or partnerships in order to participate in our housing counseling program.

I acknowledge that I have reviewed and understand the above.

Applicant’s Name Applicant’s Signature Date

Co-Applicant’s Name Co-Applicant’s Signature Date