Loan Modification/Short Sale Financial Worksheet

The following is a sample of a financial information worksheet that may be used in an application to your lender for a loan modification, or short sale consideration.

SAMPLE -- FINANCIAL INFORMATION WORKSHEET

BORROWER INFORMATION: LOAN NUMBER: ________________________
: LOAN NUMBER: ________________________
Mortgagor_________________________________________ Social Security Number_____________________

Home #___________________________________________ Work #___________________________________

Property Address_______________________________________________________________________________

Mailing Address________________________________________________________________________________

Co-Mortgagor_____________________________________ Social Security Number______________________

Home Phone #_____________________________________ Work #____________________________________

Mailing Address_________________________________________________________________________________

# Family Members ________________

**************************************************************************************

MONTHLY INCOME DATA

Description Mortgagor Co-Mortgagor Total

Net Salary $_____________ $______________ $____________

Net O/T $_____________ $______________ $____________

Commission $_____________ $______________ $_____________

Bonus $_____________ $______________ $_____________

SSI $_____________ $______________ $_____________

Alimony/Child Support $____________ $______________ $_____________

TOTAL $_____________ $______________ $_____________

*****************************************************************************

EMPLOYMENT INFORMATION

Place of Employment How Long?

Mortgagor ______________________________________ _______________

Address __________________________________________________________

Co-Mortgagor _________________________________________ _______________

Address ___________________________________________________________

EXPENSES

Monthly Obligations Monthly Payment Balance Due Past due? # months

Mortgage $________________ $_____________ _________________

2nd Lien $________________ $_____________ _________________

Other Mtg $________________ $_____________ _________________

Alimony $________________ $_____________ _________________

Child Support $________________ $_____________ _________________

Child Care $________________ $_____________ _________________

Loans

Automobile $________________ $_____________ _________________

Furniture/Appliance $________________ $_____________ _________________

Finance Company $________________ $_____________ _________________

Installment $________________ $_____________ _________________

Credit Cards

Visa $________________ $_____________ _________________

MasterCard $________________ $_____________ _________________

American Express $________________ $_____________ _________________

________________ $________________ $_____________ _________________

________________ $________________ $_____________ _________________

________________ $________________ $_____________ _________________

________________ $________________ $_____________ _________________

Utilities

Electricity $________________ $_____________ _________________

Heating/Gas $________________ $_____________ _________________

Telephone $________________ $_____________ _________________

Water/Sewer $________________ $_____________ _________________

Insurance

Homeowners $________________ $_____________ _________________

Automobile $________________ $_____________ _________________

Health $________________ $_____________ _________________

Life $________________ $_____________ _________________

Dental $________________ $_____________ _________________

Donations

Church $________________ $_____________ _________________

Charity $________________ $_____________ _________________

Dues

Union $_______________ $______________ __________________

HOA $_______________ $______________ __________________

Club $_______________ $______________ __________________

Other $_______________ $______________ __________________

Medical (not covered by insurance)

Doctor/Dentist $_______________ $______________ __________________

Hospital $_______________ $______________ __________________

Drugs $_______________ $______________ __________________

Car

Gasoline $_______________ $______________ __________________

Maintenance $_______________ $______________ __________________

Monthly Parking $_______________ $______________ __________________

Food

Family $_______________ $______________ __________________

School/Work Lunches $_______________ $______________ __________________

Clothing

New Clothes $_______________ $______________ __________________

Dry Cleaning $_______________ $______________ __________________

Uniforms $_______________ $______________ __________________

Miscellaneous

Spending Money $_______________ $______________ __________________

Cable TV $_______________ $______________ __________________

Clubs/Sports/Hobbies $_______________ $______________ __________________

Entertainment $_______________ $______________ __________________

Vacations $_______________ $______________ __________________

Gifts $_______________ $______________ __________________

IRS Liens $_______________ $______________ __________________

________________ $_______________ $______________ __________________

________________ $_______________ $______________ __________________

TOTAL Expenses: $________________ $______________ $_________________

******************************************************************************

RECAP:

Total Income: $_____________

Total Expenses: $____________

Difference: $_________________

BANKING INFORMATION

Checking Account Savings Account

Bank Name_______________________________ ______________________________________

Account #________________________________ # _____________________________________

Balance $________________________________ $______________________________________

IRA $________________________________ Stocks/Bonds $__________________________

401K $________________________________ Annuities $_____________________________

***************************************************************************************

ASSETS

Estimated Value Amount Owed Net Value

Home $_______________ $_______________ $_____________

Other Real Estate $_______________ $_______________ $_____________

Automobile $_______________ $_______________ $_____________

Make/Model $_______________ $_______________ $_____________

Automobile $_______________ $_______________ $_____________

Make/Model $_______________ $_______________ $_____________

Checking Accounts $_______________ $_______________ $_____________

Savings Accounts $_______________ $_______________ $_____________

Boat $_______________ $_______________ $_____________

Cash Value Life Ins. $_______________ $_______________ $_____________

Collections $_______________ $_______________ $_____________

Computers $_______________ $_______________ $_____________

Jewelry $_______________ $_______________ $_____________

IRA $_______________ $_______________ $_____________

401K $_______________ $_______________ $_____________

Stocks/Bonds/CD?s $_______________ $_______________ $_____________

Other Investments $_______________ $_______________ $_____________

******************************************************************************

I/we agree that the financial information provided is an accurate statement of my financial status. I understand that the Lender may verify this information at its option, by ordering a credit report,

and I agree that the Lender has my permission to do so. I understand that any legal action already taken will not be canceled until an approved work out is completed.

Submitted this ___________ day of ___________________2009.

_______________________________________

Mortgagor

_______________________________________

Co-Mortgagor

Final Instructions: Review the worksheet and make sure it is correct. Sign and date the form. Make copies of everything you have submitted and keep them for your records.