Thank you for contacting Iowa Mortgage Help. As one of several

Dear Iowa Mortgage Help Applicant:

Thank you for contacting Iowa Mortgage Help. As one of several counselors who are working on behalf of thousands of

people just like you, I applaud your willingness to seek help in finding the best possible solution to your current financial

situation.

The Iowa Mortgage Help (IMH) is a group of organizations that have come together to help communities plagued by

foreclosures. The Iowa Mortgage Help Coalition is like having your very own team of specialists to assist your family during

this difficult financial time. The Iowa Mortgage Help (IMH) Coalition consist of housing counseling agencies like ours

(Operation Threshold) who have certified housing counselors on staff, the Iowa Attorney General’s Office, Iowa Legal Aid; and

Iowa Mediation Services. All services through the Iowa Mortgage Help Coalition are FREE and CONFIDENTIAL.

The role of the housing counseling agency (Operation Threshold) is to gather and verify all needed documentation to

successfully negotiate a workable solution with your lender. As your counselor, we will work with you to complete a realistic

budget and feasible plan of action to help you determine the best course of action considering your individual circumstances.

Next, your file will be sent to Iowa Mediation Service where experienced negotiators will contact your mortgage company on

your behalf and advocate a practical solution to your mortgage situation.

Listed below are items that I will need you to complete, sign, and return to me before your appointment. We can schedule this

to take place over the phone or in my office. We need the following forms signed and return to our office along with the

other items listed below: Authorization Form, Counseling Agreement, Counselor/Client Agreement, & Privacy Statement.

Below are documents that I will need you to make copies to fax/email/mail to our office.

 All Iowa Mortgage Help disclosures and authorization forms-These forms are included

 Complete and sign the Verified Budget Form

 Complete and signed Hardship Letter

 Request for a Modification Affidavit OR Lender-Specific Forms OR Uniform borrower Assistance Form

 Consecutive pay stubs and/or other documents to show your income (must show last 60 days of income).

 2 years tax returns –All Pages.

 Your last two month’s bank statements (last 60 days)

 Dodd Frank Certification

 Most recent monthly mortgage statement from your lender that contains your loan number.

 Most Recent Utility Bill (ie: Mid-American, Alliant, CFU, etc..).

I look forward to assisting you. If you have any questions, please contact me at 319-291-2065

Mailing Address: Operation Threshold Attn: Foreclosure Prevention PO BOX 4120 Waterloo, Iowa 50704

THE NEGOTIATION PROCESS MAY TAKE SEVERAL MONTHS SO WE REQUEST THAT YOU

REGULARLY MAIL/FAX/EMAIL UPDATED COPIES OF YOUR BANK STATEMENTS AND PAYSTUBS TO

YOUR COUNSELOR AS YOU RECEIVE UPDATED DOCUMENTATION. THIS WILL HELP EXPEDITE THE

REVIEW OF YOUR FILE FOR A WORKOUT RESOLUTION.

Sincerely,

Foreclosure Prevention Counseling Program

Office 319-291-2065 Fax # 319-232-6484

www.operationthreshold.org

Mortgage Loan Negotiation Packet Checklist

Iowa Mortgage Help

Mortgage Loan Negotiation Packet Checklist

IMH Client #: _________________________ (Agency Use Only)

Operation Threshold Fax Number: 319-232-6484 Attn to: Foreclosure Prevention Dept.

_______ One of the following Financial Forms

___Making Home Affordable-Request for a Modification Affidavit (RMA)

___Uniform borrower Assistance Form ___ Lender-specific financial form

_______ Authorization to Release Information that includes:

 Property address and phone number

 Name of servicing company and loan number for each mortgage

 Signatures of everyone signed on the loan, their Social Security numbers and date release

signed.

_______Hardship letter signed and dated

______ Copies of foreclosure notices or legal documents from the lender/servicer.

______ Verification of Income (only provide copies – not originals)-NEED 2 Months

 2 most recent months pay stubs from all adult wage earners. Circle the net pay and use it to

calculate income for the budget.

 Document and verify other sources of income including pension and retirement; Social Security and

Disability; Child Support; VA payment, military retirement or Reserve pay; other income listed on

budget. If you can’t get documentation then circle and label the direct deposit of the income on the

homeowner’s bank statement.

_______ The most recent 2 months of bank statement (copies only) or you can call to have bank/credit

union fax to Operation Threshold Attn: Foreclosure Prevention Department.

_______ Complete Verified Budget Sheet that is signed

 Double check that income on the budget corresponds to pay stubs and other verification of income

provided (provide a written explanation if the calculation isn’t obvious).

 Monthly expenses should not include items already deducted out of the pay check.

 Food stamps and other irregular income should be included in the budget.

_______ Copy of 2010 and 2011 tax return-NEED ALL Pages. Page 2 of ‘1040 form’ MUST Be Signed!

_______ Copy of your most recent Utility Bill (ie Mid-American Bill, Alliant, etc…).

_______ Include the alternative phone numbers, best time to call and email address if applicable.

Email address:_______________________________ Alternative number:________________

I have $__________ saved in my bank acct to contribute to a mortgage work-out solution.

OR

I will have the following amount of money saved to contribute $_________ by Date___/____/_____.

Sign__________________________ Sign___________________________ Date__________

HOW TO SUCCESSFULLY COMPLETE YOUR PACKET

STEP 1:

DOCUMENTS YOU NEED TO READ & SIGN ONLY & RETURN WITH THE INTAKE PACKET

___ Privacy Policy ___ Consent Form ___ Dodd-Frank Certification

___ Counseling Agreement ___ Client/Counselor Contract

STEP 2:

DOCUMENTS YOU NEED TO COMPLETE & SIGN & RETURN WITH THE INTAKE PACKET

___ Request for a Modification (RMA) Form (Signed) ___ Hardship Letter (Sign the 1

st

page & 3

rd

page)

___ Mortgage Lender-Specific Forms if your lender is with= (GMAC, Chase/WaMu, Litton Loan, EMC , AHSMI)

___4506-T Form-Request for Tax Transcript (Signed) ___ Verified Budget (Signed)

STEP 3:

PERSONAL DOCUMENTS THAT WE NEED COPIES OF RETURNED WITH THE INTAKE

PACKET

___ 2 months of Pay Stubs- last 60 days

(Paid Weekly=4 consecutive paystubs, Bi-weekly=2 consecutive paystubs, Semi-monthly=2 paystubs)

___ 2 months Bank Statements (most recent-within the last 60 days and all pages --if your bank statement says

page 1 of 7, and then we will need all 7 pages.) If you do not have a bank account you need to

complete & sign a letter stating you don’t have a bank/credit union checking or savings account.

___ 2010 and 2011 Tax Returns (You MUST sign the 2

nd

page of the 1040)-See Example

___ Social Security Statement or SSI Statement or Disability (if applicable)-(If benefits are direct deposit on you

bank statement than that is ok for documenting your benefits)

___ Profit and Loss Statement-most recent quarter (if you are self-employed)

 January, February, March= 1

st

Quarter

 April, May, June= 2

nd

Quarter

 July, August, September = 3

rd

Quarter

 October, November, December= 4

th

Quarter

 3-6 MONTHS BUSINESS BANK STATEMENTS (if applicable)

___ Recent Monthly Mortgage Statement

___ Any letters or correspondence from you mortgage lender or the lenders’ attorney

___ Recent Utility Bill (ie: Mid-American Energy, Alliant, etc…)—must be from within 30 days

All of the documentation must be returned TOGETHER and in a timely manner (within 30 days) with

signatures from every person that is on the mortgage loan.

Double check to make sure bank statements and paystubs are the most recent (within 30 days).

Lastly, make sure your 2010 and 2011 tax returns are SIGNED.

Iowa Mortgage Help – Counseling Agency

Privacy Policy

OPERATION THRESHOLD 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. We may also use anonymous aggregated case file

information for the purpose of evaluating our services, gathering valuable research information and

designing future programs, and similar reasons.

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 submit a written

request to OPERATION THRESHOLD to do so.

Release of your information to third parties

1. 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.

2. 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).

3. 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.

SIGNATURE: X_________________________ SIGNATURE: X___________________________

Iowa Mortgage Help

Counseling Agreement

1. I understand that OPERATION THRESHOLD as a sub-grantee of the Iowa Mortgage Help (IMH) network 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. I understand that OPERATION THRESHOLD 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.

3. I give permission for NFMC program administrators and/or their agents to

a. Submit client level information to the IMH data collection system for the purposes of this grant; and

b. Open a file pertaining to counseling services received that may be reviewed for program monitoring and

grant compliance purposes, and

c. Conduct follow-up related to counseling services received for the purpose of program evaluation. I

acknowledge that I may opt out of (c.) following the procedure set forth below in item 4.

4. I acknowledge that I have received a copy of OPERATION THRESHOLD’s Privacy Policy. I understand that I am

agreeing that my non public personal information may be disclosed pursuant to that privacy policy, unless I opt out by

checking the box below.

5. I understand that I may be referred to other housing services of the organization or another agency or agencies as

appropriate, such as Iowa Mediation Service (IMS) or Iowa Legal Aid (ILA), which 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. In addition, I understand that if I am referred for legal advice to ILA, they can report certain information about

my case to any member of the IMH network including IMH client number, and the outcome of my case. I understand

that until ILA accepts my case, I am responsible for any deadlines surrounding my case.

6. 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.

7. I understand that OPERATION THRESHOLD provides information and education on numerous loan products and

housing programs and I further understand that the housing counseling I receive from OPERATION THRESHOLD in

no way obligates me to choose any of these particular loan products or housing programs.

Client’s signature X________________________________ Date______________________

Client hereby “opts-out” of disclosure of non public personal information pursuant to OPERATION THRESHOLD’s

privacy policy.

Authorization to Release Information

Level II

Borrower:________________________________________________________________

Last Four Digits of Borrower Social Security Number: ___ ___ ___ ___

Co-Borrower: _____________________________________________________________

Last Four Digits of Borrower Social Security Number: ___ ___ ___ ___

Co-Borrower: _____________________________________________________________

Last Four Digits of Borrower Social Security Number: ___ ___ ___ ___

Property Address: ______________________________________ Zip code ____________

Telephone Numbers: _____________________ Email: ____________________________

Lender: _______________________________ Loan Number: ______________________

Servicer: ______________________________ Conventional ( ) FHA ( ) VA ( )

Agency: IOWA MEDIATION SERVICE (IMS) / OPERATION THRESHOLD (OT)

IMS/OT Counselor ____________________________________ Telephone ________________________

Email ________________________________________________________________________________

I/we authorize that agency named above (herein after “Agency”) and its representatives to speak with my/our lender and with

whomever have servicing responsibilities for my/our loan and to provide to such parties documentation on my/our behalf

regarding my/our loan. I/we also authorize the lender and/or servicer handling my/our loan to discuss my/our loan with the

Agency, including notification of loan modification status or future default or delinquency.

The Agency agrees to maintain the confidentiality of borrower(s) information; however, I/we also authorize the Agency and/or

lender and/or servicer handling my/our loan to submit my/our personal information to the entities funding this program or their

agents for the exclusive purposes of program evaluation and monitoring.

I/we further authorize the Agency and/or lender and/or servicer handling my/our loan to access my/our credit report file(s) for

debt/expense verification in conjunction with my/our foreclosure counseling or qualification for loan refinance or modification.

This authorization will not be valid unless signed below by all borrowers and co-borrowers named above and will only remain

valid until revoked in writing by any borrower or co-borrower named above.

X__________________________________________________ _____________________

Borrower Date

X__________________________________________________ _____________________

Co-Borrower Date

__________________________________________________ _____________________

IMS/OT Counselor Date

Counselor and Client Contract

Operation Threshold and its staff agree to provide professional foreclosure prevention counseling

services to ___________________________________________. Counselors are not able to prevent

foreclosure in every situation but we are committed to working with you so you can make the best

decision possible for you individual situation. As part of the services offered, we will provide the

following:

 Assistance with the development of a delinquency budget and monthly spending plan.

 Analysis of the mortgage default, including the amount and cause of default.

 Assistance communicating with the mortgage servicer, negotiator; and other creditors.

 Identification of additional resources and make referrals to other agencies/resources.

 Maintain confidentiality, honesty, respect and professionalism in all interactions.

 Provide reasonable options available to you, the homeowner.

 Explanation of the collection and foreclosure process (We do not provide legal advice).

 Timely completion of promised action(s).

I/We, agree to the following terms of service:

 I/We will always provide honest, accurate; and complete information to my/our counselor,

whether verbally or in writing.

 I/We will provide a complete intake packet within 14-20 days of initial contact from Operation

Threshold and provide follow-up information within the timeframe requested.

 I/We will be on time for appointments and understand that if we are late for an appointment (15

minutes or more), the appointment will still end at the scheduled time and/or be rescheduled.

 I/We will call within 24 hours of a scheduled appointment if I/we will be unable to attend an

appointment.

 I/We will contact the counselor about any changes in our situation immediately.

 I/We understand that if I arrive at an appointment under the influence of any illegal substance

the appointment will be ended immediately and counseling services may be terminated.

 I/We understand that I may not threaten (verbally or physically), harass, curse or disrespect

my/our counselor; or counseling will be terminated immediately and legal actions maybe pursed.

 I/We understand that breaking this agreement may cause the counseling organization to

terminate its service assistance with me/us.

X

Borrower Date

X

Co-Borrower Date

Counselor Date

Iowa Mortgage Help

Income Calculations Worksheet

CHECK ALL YOUR SOURCES OF INCOME:

_____Wages/ Commission ____ SSI ____Social Security ____Pension/Retirement

_____ Unemployment ____Self-Employment ____Alimony ____Child Support

WHAT IS YOUR PAY PERIOD?: $______ Weekly $______Bi-weekly $______Semi-monthly

$______ Monthly $______Quarterly $______ Other (Explain__________________________)

PAID WEEKLY

$_______RATE PER HOUR AND _______ # OF HOURS YOU WORK PER WEEK (SELF)

$_______RATE PER HOUR AND _______ # OF HOURS YOU WORK PER WEEK (SPOUSE)

PAID BI-WEEKLY

$_______RATE PER HOUR AND _______ # OF HOURS YOU WORK PER WEEK (SELF)

$_______RATE PER HOUR AND _______ # OF HOURS YOU WORK PER WEEK (SPOUSE)

PAID SEMI-MONTHLY

$_______RATE PER HOUR AND _______ # OF HOURS YOU WORK PER WEEK (SELF)

$_______RATE PER HOUR AND _______ # OF HOURS YOU WORK PER WEEK (SPOUSE)

SELF-EMPLOYMENT INCOME

$___________ (MONTHLY) $_________ (QUARTERLY)

OTHER SOURCES OF INCOME: (GIVE THE MONTHLY AMOUNT)

FOOD STAMPS? $_________

PENSION INCOME: $___________

SOCIAL SECURITY $___________ S OCIAL SECURITY FOR SPOUSE $___________

(TOTAL GROSS INCOME FOR PRIMARY CLIENT) $____________________

(TOTALGROSS INCOME FOR SPOUSE) $_________________________

COMBINED GROSS MONTHLY INCOME: $_____________________________

HOW MUCH MONEY DO YOU HAVE SAVED $________________Date: _____/_____/______

FOR A CONTRIBUTION TO A LOAN WORKOUT?

Iowa Mortgage Help

Verified Budget

Gross Monthly

Income Calculation

Borrower

Co-Borrower

Total

Monthly Gross

Wages

Overtime

IMH#:_________________

Net Income Calculation

Child

Support/Alimony

Social Security/SSDI

Borrower Net Wage Income

Other pensions,

annuities, retirement

Co-borrower Net Wage Income

Tips, commissions,

bonus, self-employed

Other

Rents Received

Other

Unemployment

Income

Total Net Income

Welfare/Food Stamps

Total Monthly Expenses

Investment Income

Income less Expenses

Total Income

Monthly Expenses as Verified by Counselor

Amount

Notes

1st Mortgage Payment

House DTI :

2nd Mortgage or Home Equity Loan

House DTI w/2nd :

Property Taxes (subtract from payment if included)

Property Insurance (subtract from payment if included)

HOA/Condo Fee

Net Rental Expenses

Auto Loan #1

Auto Loan #2

Auto Insurance

Auto Fuel & Repairs

Credit Card Payment(s)

# of cards

Alimony

Child Support

Student Loans

How many payments left?

Other Loan:

Gas and Electric

Garbage and Water

Groceries (not dining out)

Clothing

Telephone (not mobile phone)

Health Care Costs

Home Repairs and Supplies

Childcare

Other Dependent Expenses

Cable or Satellite TV

Mobile Phone (s)

Entertainment & Dining Out

Internet Access

Beer, Alcohol, Cigarettes and Tobacco

Miscellaneous expenses

Total Expenses

X

Signature Above

Date

X

Signature Above

Date

RMA - Monthly Household Expenses/Debt

Amount

Notes:

First Mortgage Payment

Second Mortgage Payment

Insurance

Property Taxes

Credit Cards/Installment Loans

Alimony, Child Support

Net Rental Expenses

HOA/Condo Fees/Property Maintenance

Car Payments

Other

Total Debt/Expenses

Iowa Mortgage Help –Letter of Hardship

Borrower Name

Co-Borrower Name

Property Address

City, State, Zip

First Mortgage Second Mortgage

Lender Name

Loan Number

Lender Name

Loan Number

I am (we are) requesting that Lender/Mortgage Servicer / Investor / Insurer review my financial situation to see if I

qualify for any loan workout option. I am having problems making my monthly payment because of financial

difficulties created by:

Unemployment

Reduced Income

Divorce

Separation

Medical Bills

Too Much Debt

Death of a Spouse

Payment increase

Business failure

Job Relocation

Illness

Incarceration

Military Service

Damage to Property

Other

If Other, please explain:

____________________________________________________________________________________________

I believe that my situation is

Temporary

Permanent

Sincerely,

__________________________________________ _____________

Borrower’s Signature Date

__________________________________________ _____________

Co-Borrower’s Signature Date

The following questions are to be answered by the homeowner. If necessary please attach an additional

sheet.

What event(s) caused your financial hardship?

_______________________________________________

What was the term of your hardship? (When did it begin? Has it ended?).

What was the financial impact of your hardship? (Estimated expense of hardship, income lost during the

hardship, etc.)

Are you currently employed:

Yes No

If you answered yes, how long have you been with your current employer?

Are there any foreseeable changes in your employment?

_________________________

How long have you lived at the property? Have you considered selling the property? If so, please

describe why you would want to sell your home. If not, please describe why you want to keep the

property.

_______________________

What actions have you taken so far to resolve your financial situation? (Example: obtained additional

employment, reduced optional monthly household expenses)

_______________________________________________

All of the information that I/We have provided in this worksheet is correct and factual. No information has been withheld.

Signature Date

Confirmation of No Bank Account Letter

Name:_____________________________ Date: _____/____/______

Address:___________________________

____________________________

TO WHOM IT MAY CONCERN:

I, ______________________________, am writing this letter to confirm that

(Name Here)

as of ___________________(date); I do not have any active or open bank/credit union account

with any banking or credit union institutions.

Sincerely,

Borrower Signature:____________________________ Date:________________

Co-Borrower Signature:____________________________ Date:________________

Only complete if you do not have a savings or checking account

Home Owner's Association Dues

Print Name: ________________________________________

Lender: ___________________________________________

Loan #: _______________________________________________

Please check one that applies:

 We do not have any homeowner's association dues

 We DO have homeowner's association dues in the amount of: $________

o Are you delinquent on your Homeowner’s Association Dues Y or N

o What is the delinquent amount of your HOA dues? $_________

By signing I certified that the above statement is true:

______________________________________ ____________________

Borrower Signature date

_____________________________________ ____________________

Co-borrower Signature date