The Law Firm of

Loan Modification
Mark Stumer P.C.
Package

PLEASE COMPLETE AND SIGN

THE FOLLOWING DOCUMENTS
ATTACHED TO THIS
APPLICATION:

1. Modification Starter
2. Financial Statement
3. Third Party
Authorization
4. Service Agreement
5. Retainer Agreement
6. Notice of Cancellation
part 1
7. Notice of Cancellation
part 2
8. Payment Authorization
9. Hardship Letter

PLEASE SUBMIT THE

FOLLOWING DOCUMENTS
WITH THIS APPLICATION:

Mortgage Note
Most Recent Mortgage
IMPORTANT REMINDER Statement
2 Months Pay Stubs
During the modification process of your loan, it is 2 Months Bank
your responsibility to make any and or all Statements
payments to the best of your ability on all loans 2 Years W-2’s and Tax
under their current terms. If you are capable of Returns
making payments during the negotiation process,
continuing to do so may or may not benefit your
negotiation. It is in your best interest to continue making your loan payments we
encourage you to do so.

Please sign and date below to verify you have read and understand this notice.
____________________ _____________
Signature Date

____________________ _____________
Signature Date
 1. MODIFICATION STARTER
Date of Application Account Executive

PERSONAL INFORMATION

Name Co-Borrower

SSN SSN

Address Address

Home Phone Home Phone

Cell/Work Cell/Work

Fax Fax

Email Email

PROPERTY INFORMATION

Interest Rate Type of Mortgage q Fixed q ARM

q Other
Home Value $ Mortgage Balance $

Annual Taxes $ Date of last Refinance

Are Taxes Current? q Yes q No Escrow in Mtg. Payment? q Yes q No

Has Borrower been late on any payments? q Yes q No
Mortgage Lender Loan #

Approximate equity left in house $

Name(s) on Deed

EMPLOYMENT INFO
Name of Employer Name of Employer

Address Address

Position Years Position Years

Gaps Gaps

Credit Status Credit Status

q W-2 or q 1099 (Self-employed) q W-2 or q 1099 (Self-employed)

Lost job or income lowered? q Yes q No Lost job or income lowered? q Yes q No

2. FINANCIAL STATEMENT

Borrower Name Social Security/DOB Home Phone Business/Cell Phone

Borrower Employer Position/How Long Monthly Net Income Rental/Other Income

Co-Borrower Name Social Security/DOB Home Phone Business/Cell Phone

Co-Borrower Employer Position/How Long Monthly Net Income Rental/Other Income

Property Address Street City State ZIP How long

have you owned?

_____
_____ Years
Mailing Address Street City State ZIP Number
of Dependents?

MONTHLY EXPENSES ASSETS

Alimony $ Description Estimated Amount Net Value
Auto Insurance $ Value Owed
Auto Loan $ 401(k)
Auto Loan $ Vehicle
Gas/Parking $ Year Model
Cable TV/Sat. $ Vehicle
Child Care $ Year Model
Club/Union Dues $ Cash
Credit Card Bills $ C.O.D.
Dry Cleaning $ Checking
Other Loans $ IRA
Groceries $ Life Insurance
Gas, Water, Electric $ Mutual Funds
Home Owners Insurance $ Other Real
Life Insurance $ Estate
Medical Expenses $ Personal
Other Mortgage $ Property
Rent $ Primary Home
Church/Charity $ Savings
Tuition $ Stocks/Bonds
Spending Money $ Other
Property Taxes $
Telephone $
Other $

Borrower Signature Date

Co-Borrower Signature Date

3. THIRD PARTY AUTHORIZATION

Third Party Authorization and Agreement to Release

Loan Number

Name(s)
Property Address

For the purpose of assisting in pursuing and negotiating a loss mitigation alternative, I do
hereby give my written permission to __________________________ (my
lender/mortgage servicer) to release or to otherwise provide to
_____________________________________ of
The Law firm Mark Stumer P.C. in his/her capacity as
_________________________ _________________________
Relationship (if applicable)
Phone #
Public and non-public personal finance information contained in my loan
account which may include, but is not limited to, loan balances, final payoff
statements, loan status, payment history, payment activity, and/or property
information.
We, the lender/mortgage servicer will take reasonable steps to verify the
identity of the 3rd party authorized above, but will have no responsibility or
liability to verify the true identity of the requestor when he/she asks to
discuss my account or seeks information about my account. Nor shall we, the
lender/mortgage servicer, have any responsibility or liability for what the
requestor may do with the information he/she obtains concerning my
account.
I do hereby indemnify and forever hold harmless the lender/mortgage
servicer, from all actions and cause of action, suits, claims, attorney fees, or
demands against the lender/mortgage servicer which I and/or my heirs may
have resulting from the lender/mortgage servicer discussing my loan account
and/or providing any information concerning my loan account to the above
named requestor or person identifying themselves to be that requestor.

Printed Customer Name

Customer Signature Date

 4. SERVICE AGREEMENT
_______________________________ Hereinafter (“Client”) agrees to retain The Law Firm
of Mark Stumer P.C. for the purpose of modifying Client’s current mortgage on the
property known as
______________________________________________________________________________________
_.

We appreciate your confidence in our firm and, while we can make no

guarantee as to the outcome of your matter, we will keep you Updated as to the
status of your modification. In turn, you will cooperate with us so that we can
properly handle your matter.

The Law Firm of Mark Stumer P.C. fee for services rendered by us to you is
_______________________________________________________________(The “Fee”). Payment
shall be made as follows: a onetime fee of_________________________ dollars that is a
NON-REFUNDABLE ______ ( INITIAL ) processing and retainer fee, due upon
completion of your initial package (payable to the The Law Firm of Mark Stumer
P.C.). Mortgage modification may consist of but not limited to, change of interest
rate, change of length (term) of loan, a forbearance agreement arranged, waiver of
late charges and a change from an adjustable interest rate to a fixed interest rate.

Payment is to be made by credit card, debit card, money order or bank/official

check. No other forms of payment will be accepted. In the event that you fail to
cooperate or provide us with inaccurate or false information, The Law Firm Of Mark
Stumer P.C. may decline to proceed with your matter and retain the amounts already
paid. Additionally, the client understands that upon acceptance of funds, the client is
to immediately discontinue all communications with their lending institution(s) unless
otherwise authorized by The Law Firm of Mark Stumer P.C., and any breach of this
condition can jeopardize The Law Firm of Mark Stumer P.C. negotiating proceedings
and voids the aforementioned return policy.

This agreement states the total understanding between The Law Firm of Mark
Stumer P.C. and you as to the scope of service we are providing on your behalf. It
authorizes us to act on your behalf and an execution of this agreement indicates a
commitment by both parties to be bound by its terms. The laws of the State of New
York shall govern these terms. Once again, thank you for the confidence you have
placed in us. We look forward to working with you and serving your interests.

Very Truly Yours,

The Law Firm of Mark Stumer

____________________________
By:

Accepted and agreed by:

_____________________________ Date _____________

Signature
____________________________ Date _____________
Signature
 5. RETAINER AGREEMENT

The Law Mark Stumer P.C.

73 Ireland Place
Suite 204
Amityville, NY 11701

(Part 1 of 2)

Re: Modification of Existing Mortgage Loan

Dear Sir / Madam,

You are hereby retaining the law firm of Mark Stumer P.C. to represent you in
negotiating a possible modification of your existing mortgage. The Law Firm Mark
Stumer, P.C its partners, associates, paralegals, or other personnel assigned to your file
specifically are not making any guarantee that they will be able to secure a modification
of your existing loan.

It is the firm’s customary practices, and it is now a requirement of the Office of

Court Administration, to provide you, as our prospective client, with a written
engagement letter with respect to our engagement and representation.

You shall initially pay us a retainer and processing fee of ____________ This fee
encompasses our review of the modification package and negotiation of a possible
modification of your existing loan.

By executing this agreement you specifically acknowledge that the fees being
accepted are on behalf of The Law Firm of Mark Stumer P.C. We remind you that we are
your attorney and represent you.
 (Part 2 of 2)

The Law Firm of Mark Stumer P.C.

73 Ireland Place
Suite 204
Amityville, NY 11701

A mortgage modification may consist of, but not be limited to, change of interest
rate, change of terms, forbearance agreement, waiver of late charges and/or principal or a
change from an adjustable interest rate to a fixed interest rate.

The foregoing fees are due regardless of the amount of time spent on your file.
Your fees are also capped at this rate.

It is understood that this retainer is limited to the services referred to above. It does
not include any other legal services, including, but not limited to commencing or
defending any litigation, bankruptcy filing or counseling regarding insolvency or other
proceedings, court appearances of any kind or nature or any legal services outside the
scope of this agreement.

It is further understood that the retainer fee does not include any out of pocket
disbursements, which will be billed for separately. Out of pocket expenses include, but
are not limited to long distance telephone calls if needed, postage and photocopies.

This Agreement may not be changed except in writing signed by the parties.

If this arrangement meets with your approval, kindly sign your name in the space
provided below and return it to us together with your bank or certified check in the
amount of $_____________. You may also pay by personal check or money order.

We are delighted to have the opportunity to work with you and appreciate your
confidence in us.

The Law Firm of Mark Stumer P.C .

By: ___________________________
Mark Stumer, P.C
The foregoing terms and conditions
Have been read and are understood.
They are agreed to and accepted.
_______________________________
_______________________________

6. NOTICE OF CANCELLATION

(Part 1 of 2)

You may cancel this contract, without any penalty or obligation, at any time
before midnight of

(If blank then effective 5 calendar days

from execution of this Notice)

To cancel this contract, sign and date both copies of this cancellation notice
and personally deliver one copy or send it by facsimile, United States mail,
or an established commercial letter delivery service, indicating cancellation
to the Distressed Property Consultant at one of the following:

The Law Firm of Mark Stumer P.C.

73 Ireland Place
Suite 204
Amityville, NY 11701

I hereby cancel this transaction.

Name of Homeowner

Signature of Homeowner

Date
 7. (Part 2 of 2)

NOTICE REQUIRED BY LAW

You may cancel this contract, without any penalty or obligation, at any time
before midnight of _________

_______________________ (if blank then effective 5 calendar days from

execution of this Notice) or anyone working for the Consultant may not take
money from you or ask you for money until the Consultant has completely
finished doing everything this contract says the Consultant will do.

You should consider consulting an attorney or a government-approved

housing counselor before signing any legal document concerning your
home. It is advisable that you find your own attorney, and not consult with
an attorney recommended to you by the Consultant. A list of housing
counselors may be found on the website of the New York State Banking
Department, www.banking.state.ny.us or by calling the Banking Department
toll-free at 1-877-BANK-NYS (1-877-226-5697). The law requires that this
contract contain the entire agreement between you and the Consultant. You
should not rely upon any other written or oral agreement or promise.

Name of Homeowner

Signature of Homeowner

Date
 9. HARDSHIP LETTER

Dated:

To: Whom it May concern

RE: Explanation of Financial Hardship

I/we are having problems making my/our monthly payment because of financial
difficulties created by:
(Check all that apply)

____ Business failure ____ Illness ____ Military Service

____ Death of Spouse ____ Incarceration ____ Reduced Income
____ Disability ____ Job Relocation ____ Too much debt
____ Divorce ____ Medical Bills ____ Unemployment

Other (Please specify)

_______________________________________________________________________
_

I/We believe that my/our situation is: ______Temporary _______Permanent

Following is an explanation of the events, which lead up to this hardship: