Mortgage Creditor Checklist {Y-1}

VTB FORM Y-1 09/10 MORTGAGE CREDITOR CHECKLIST Debtor Name(s):_________________________________________ Ch 13 Case #:______________________ Property Address: ___________________________________________________________________________ Daytime Phone: ( ) ______________ Evening: ( ) ______________ Email: ________________________ Attorney name (if any):_______________________________________________________________________ THE FOLLOWING INFORMATION MUST BE COMPLETED FOR ALL MORTGAGES. PLEASE BE SURE TO COMPLETE THIS FORM TO THE BEST OF YOUR ABILITY AND ATTACH THE THREE (3) MOST RECENT MORTGAGE INVOICES OR MONTHLY PAYMENT VOUCHERS SUPPLIED BY YOUR MORTGAGE CREDITOR(S). IF YOU DO NOT HAVE CURRENT INVOICES OR PAYMENT VOUCHERS, YOU ARE ENCOURAGED TO CONTACT YOUR MORTGAGE CREDITOR, OR HAVE YOUR ATTORNEY CONTACT YOUR MORTGAGE CREDITOR'S ATTORNEY, PRIOR TO COMPLETING THIS FORM, TO ENSURE THAT THIS FORM IS CORRECT. PLEASE SEND THIS FORM, WITH ATTACHMENTS, TO THE TRUSTEE FOR EACH CREDITOR TO WHOM YOU GRANTED A MORTGAGE ON YOUR HOME, AND PROVIDE A COPY TO THE MORTGAGE CREDITOR. DO NOT FILE THIS FORM WITH THE COURT. Creditor Name: _____________________________________________________________________________ ___Servicer ___Original Lender ___Other (Please Explain) _________________________________________ Last 4 digits of any number used to identify the Mortgage Loan: ______________________________________ Payment Address: __________________________________________________________________________ Street Address __________________________________________________________________________________________ City State Zip Creditor Phone (if known): ( ) ______________ Email (if known):__________________________________ Monthly Payment Amount: $______________ Current Interest Rate: ______% Grace Period: ______________ Monthly Due Date: ______________ Date Payment Late: ___________ Late Charge Amount: _____________ Is this a variable interest rate loan? ___Yes ___No If yes, when is the next anticipated adjustment date? ___________________________________ Are property taxes included in the monthly payment? ___Yes ___No If yes, what is the amount of the property taxes? $______________________________________ Is insurance included in the monthly payment? ___Yes ___No If yes, what is the amount of the insurance? $_________________________________________ Is the loan due in full and payable in less than five (5) years? ___Yes ___No If yes, what is the date due? _______________________________________________________ Are you behind on payments on this loan? ___Yes ___No If yes, by how many months? _____________________________________________________ Has a foreclosure action been commenced? ___Yes ___No If yes, what is the case number? ___________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com