Financial Worksheet For Loan Modification {10}

VTB MM Form # 1010 VTB Form - MM # 11/14/2011 12/16/11 Financial Worksheet for Loan Modification XXX-XXBorrower Name_______________________________________________Social Security #_________________________________ XXX-XXCo-Borrower Name____________________________________________Social Security #_________________________________ State Property Address___________________________________________City________________________Sate____Zip__________ State MailingAddress_____________________________________________City________________________Sate____Zip__________ Home Phone__________________Work Phone____________________Cell_____________________Fax___________________ Best time to Call_________________________Email______________________________________________________________ Borrower Employer_____________________________________ Full-Time Part-Time Unemployed Self-Employed Retired Part-Time Unemployed Self-Employed Retired Monthly Monthly Quarterly Quarterly Yearly Yearly Occupant Employer_____________________________________ Full-Time Borrower Income Frequency Additional Occupants Income Frequency st Weekly Weekly Bi-Weekly Bi-Weekly Semi Monthly Semi Monthly nd Mortgage Company Name: 1 ______________________________________2 ______________________________________ Loan Number 1 ______________________________________ 2 st nd ______________________________________ Income Income Disability Rental Unemployment Child Support Other Total Borrower Income Gross Net Occupant Income Gross Net Assets / Liabilities Description Value Owe Net Auto Checking/Saving IRA 401K Stocks/Bond/CDs Other Total Household Liabilities and Expenses Payments Balance Due Expenses Clothing Dry Cleaning Monthly Parking Club or Union Dues School or Work Lunch Cost HOA Dues / condo dues Other Food/groceries/meals Debts Dining Out Auto Loan Credit Cards Installment Loans Mortgage Payment nd 2 Loan Payment Property Tax & Insurance Personal Loans Other Secured Debts Other Unsecured Debts Other Total Expense / Debts Payments Balance Due Expenses Alimony Child Support Auto Expense(gas repairs) Child Care/Elder Care Other Mortgages Entertainment Education Medical Pets Spending Money Other Plan pmt Ch 13Expenses Auto Insurance Health Insurance Life Insurance Hospital Prescriptions Cable Electricity Gas Phone/Cell/Internet Water/Sewage Debtor signature: ________________________ Date signed: _____________ Co-Debtor signature:_______________________ Date signed: _____________ American LegalNet, Inc. www.FormsWorkFlow.com