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THE SHORT SALE DIVISION
25600 Woodward Ave.
Suite 200
Royal Oak, MI 48067
Toll Free:
(877) 544-3320
Phone:
(248) 544-3370
Fax:
(248) 544-3663
contact@theshortsaledivision.com
Applicant Info
Lender Info
Employer Info
Assets / Liabilities
Hardship Info
Applicant Information
Name:
Address:
Address:
City:
State:
Select
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Subject Property:
Yes
No
Address:
Address:
City:
State:
Select
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Property Type:
Single Family
2-4 Unit
Condo
Other
Property Value:
$
Property Purchase Date:
MM
01
02
03
04
05
06
07
08
09
10
11
12
/
YYYY
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Date of Birth:
SSN:
Married:
Single
Married
Divorced
Dependants:
Cell Phone:
Home Phone:
Work Phone:
Email:
Lender Information
Lender Name:
Account #:
Loan Type:
Conventional
FHA
VA
Mortgage Type:
Fixed
Adjustable
IO
Balloon
Mortgage Rate:
Current Loan Balance:
$
Original Loan Amount:
$
Last Refinance Date:
MM
01
02
03
04
05
06
07
08
09
10
11
12
/
YYYY
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Current Monthly Payment:
$
Payment includes taxes & insurance?
Yes
No
Annual Tax Amount:
$
Annual Insurance Amount:
$
Employer Information
Type of Employment:
Self Employed
Wage Earner
Fixed (SSI/Pension)
Employer Name:
How Long?
0
1
2
3
4
5+
year(s)
0
1
2
3
4
5
6
7
8
9
10
11
12
month(s)
Total Monthly Household Income:
$
Additional Income Comments:
Assets
Asset/Bank Name
Current Balance
Checking
$
Savings
$
401K
$
Other
$
Other
$
Total Assets:
$0.00
Expenses / Liabilities
Expense Name
Monthly Payment
Car 1
$
Car 2
$
Car Insurance
$
Credit Card
$
Cable / Internet
$
Cell Phone
$
Utilities
$
Gasoline
$
Groceries
$
Student Loans
$
Other
$
Other
$
Other
$
Total Monthly Expenses:
$0.00
CHECK THIS BOX TO CLAIM ZERO EXPENSES / LIABILITIES:
(Otherwise, please ensure you have at least ONE expense filled in above.)
Hardship Information
1. Do you want to stay in your home?
Yes
No
2. Are you current on your mortgage?
Yes
No
How many months delinquent?
3. Have you applied for a loan mod?
Yes
No
When?
MM
01
02
03
04
05
06
07
08
09
10
11
12
/
YYYY
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
4. Have you filed bankruptcy?
Yes
No
Bankruptcy Type
Select
Chapter 7
Chapter 13
File Date:
MM
01
02
03
04
05
06
07
08
09
10
11
12
/
YYYY
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Discharge Date:
MM
01
02
03
04
05
06
07
08
09
10
11
12
/
YYYY
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
Required Fields
Phone: (877) 544-3320 | Fax: (248) 544-3663 | 25600 Woodward Ave | Suite 200 | Royal Oak, MI 48067