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Making Home Affordable Program

Hardship Affidavit

COMPLETE ALL TWO PAGES OF THIS FORM

HARDSHIP AFFIDAVIT page 1
Loan I.D. Number____________________________________

Servicer ____________________________________

BORROWER

CO-BORROWER

Borrower’s name

Co-borrower’s name

Social Security number

Date of birth

Social Security number

Date of birth

Property address (include city, state and zip):

I want to:

Keep the Property

Sell the Property

The property is my:

Primary Residence

Second Home

Investment Property

The property is:

Owner Occupied

Renter Occupied

Vacant

HARDSHIP AFFIDAVIT
I (We) am/are requesting review under the Making Home Affordable program.
I am having difficulty making my monthly payment because of financial difficulties created by (check all that apply):
My household income has been reduced. For example: unemployment,
underemployment, reduced pay or hours, decline in business earnings,
death, disability or divorce of a borrower or co-borrower