First Name

Last Name

Address of the Property you Need Assistance with

City

State

Zip Code

County

Type of Home

 Single Family Home

 Towhouse

 Condo

 Duplex

 Mobile Home

 Manufactured Home

 Vacant Land

 Commercial

 Other

Phone Number

Alternate Phone Number

Email Address

When is the best time to reach you?

 Morning    Afternoon    Evening  

How did you hear about JMH Properties?

My main goal is to...

 Sell my house.

 Keep my house.

Please tell us about your challenges with the house. How did you fall behind on your mortgage payments?

Number of Bedrooms

Number of Bathrooms

Square Footage of the House

Garage

 No Garage

 Carport

 2 Car Garage

 3 Car Garage

 4 Car Garage

 Other

Pool

 Yes    No  

Fireplace

 Yes    No  

View

 Conservation

 Lake

 Pond

 River

 Canal

 Ocean

 Intracoastal

Subdivision / Community Name

Who is the lender for your 1st Mortgage?

Loan Type:

 Conventional

 FHA

 VA

 Private Mortgage

 Other

How much do you owe (total) on the 1st Mortgage?

How much are your monthly payments on your 1st Mortgage?

What was the date of your last mortgage payment?

Who is the lender for your 2nd Mortgage (if applicable)?

2nd Mortgage Loan Type

 Conventional

 FHA

 VA

 Private Mortgage

 Other

How much do you owe (total) on the 2nd Mortgage?

How much are your monthly payments on your 2nd Mortgage?

What was the date of your last mortgage payment?

Are there any other mortgages, liens or judgments on the house? If yes, please describe.

Are your taxes current? If no, how much do you owe?

Are your Homeowners Association dues current? If no, please describe.

Have you recently filed bankruptcy?

 Yes

 No

 I'm thinking of filing bankruptcy.

Are you willing to sell the house for what you owe in order to get our from under the debt and avoid foreclosure? If no, please tell us what you would like to get from the sale.

Have you had the house appraised recently? If yes, please tell us the appraised value of the home. If no, an approximate value will do.

Is your house currently listed with a Realtor? If yes, please tell us the listed price.

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