Dear Homeowner, You Are Not Alone - NeighborWorks Umpqua

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605 SE Kane StreetRoseburg, OR 97470Phone: 541 673-4909Fax: 541 673-5023Dear Homeowner,You are not alone:Thank you for contacting NeighborWorks Umpqua, we understand that no one enters into their mortgage loanexpecting to have trouble making their payments. Life changes and unexpected hardships can happensuddenly, catching even the prepared off guard. Dealing with being in default with your mortgage can be adifficult life experience but you don't have to go through it alone.Who we are: NeighborWorks Umpqua was established in 1991 with the goal of developing affordable housing,assisting first time home buyers and to promote economic development in Douglas, Coos and CurryCounties. NeighborWorks Umpqua provides educational classes, rehab opportunities, programs andcounseling services through two housing centers; Umpqua Regional Housing Center, serving DouglasCounty residents, and Umpqua Coastal Housing Center, serving Coos and Curry county residents. In response to the foreclosure crisis NeighborWorks Umpqua became a part of the NationalForeclosure Mitigation Counseling Program in 2008.Key points to know: There is no cost to you for our counseling services. Once a complete intake packet has been assembled and returned to our office, a counselor will callyou to set up an appointment. It will be very important that you establish a relationship andcommunicate with your assigned counselor. On the following is a checklist and all the necessary forms you will need to get you started, pleasecontact us at 541-673-4909 if have any questions.building homes, building communities, building liveswww.nwumpqua.org

CLIENT BILL OF RIGHTS AND RESPONSIBLITIESNeighborWorks Umpqua is committed to providing you with high quality professional services.NeighborWorks Umpqua does not discriminate in the selection and participation of clients in itsprograms with respect to race, religion, color, gender, age, national origin, or disability.Client RightsTo be treated with dignity and respectTo have your information treated with confidentialityTo be actively involved in any plan which may be developed for youTo have program requirements explained to youTo have any complaints addressed in a timely mannerTo ask questions and be informed of your rightsTo discontinue your relationship with us at anytimeClient ResponsibilitiesTo speak in an appropriate manner to have your concerns addressedTo provide accurate up to date information to the person(s) assisting youTo understand the requirements of the program(s) you are participating in and to fulfill thempromptlyTo ask questions when you need clarificationTo keep your appointments and when unable to do so provide 24 hrs. advance noticeTo arrive promptly for your appointments

How To Avoid Foreclosure Scams!Are you in danger of foreclosure and don’t know where to turn?If someone promises to help you negotiate with your lender to lower your homeloan payments or save your house, STOP! Oregon law limits upfront fees inmost cases and requires companies to be licensed. The license number must bedisplayed in all advertising. Call 866-814-9710 to verify a license.Scammers use public records to target people who have mortgage loans or whoare in the foreclosure process. They also target limited English speakers andsenior citizens. BEWARE!Scammers often Make themselves look like an official agencyPortray themselves as licensed attorneys or working with licensed attorneysGuarantee or promise positive resultsSet up fictitious websites and toll-free numbers that look officialAsk for personal financial information, such as your bank accounts andSocial Security number Tell you not to make payments or contact your lender or anonprofit counselor Advertise on radio, TV, the Internet, or send mail to youCONSUMERS SHOULD: Verify the company is properly licensed with the State of OregonContact their mortgage company to ask questions about their loanContact a nonprofit housing counseling agency by first calling 2-1-1Contact an attorney only if he or she is an active member of the OregonState BarCONSUMERS SHOULD NOT: Pay money up front for help negotiating with their lenderSend the loan payments to anyone other than their lendersGive their financial information before they verify licensing or registrationSign documents or contracts they don’t completely understandFor more information about how to file a complaint, verify a license, or otherresources, call 866-814-9710 (toll-free) or visithttp://www.foreclosurehelp.oregon.gov/.Since 2010, Oregonians have lost nearly 500,000 to illegal companiesoffering “help.”Información en español al reverso440-4954 (12/12/COM)

Documentation ChecklistNeighborWorks Umpqua cannot proceed with your appointment without the required documents. Documentswill not be returned. Your appointment will be rescheduled if you do not have copies of the requesteddocuments at the time of your appointmentNeighborWorks Umpqua Forms: Intake Form (2 Pages) Foreclosure Intervention Application (2 Pages) Referral For Translation Services Form (1 Page) Client/Counselor Agreement (1 Page) Foreclosure Mitigation Counseling Agreement/ Third Party Authorization Form (1 Page) Authorization To Release Information (1 Page) Disclosure and Authorization to Release Information (1 Page) Credit Report Authorization Form (1Page) Privacy Policy and Practices (1 Page) Personal Monthly Budget (1 Page)Personal Documentation (Single Sided Copies Only): Mortgage Note and Deed of Trust- All pages Mortgage Statements- Most recent, need all pages for 1st & 2nd Mortgages Letter(s) from your mortgage company regarding your delinquency Property Tax Statement- Most recent Utility Bill- Most recent, needed to prove residency Monthly Bank Statements- Last 2 Months, for all accounts, all pages Federal Tax Returns- Last 2 Years, page two must be signed & dated Drivers License 1 Month Proof of Income(s) Paystubs for most recent 30 day period Social Security Award Letter Proof of pension Unemployment Benefit Statement Other Income: If Self-Employed YTD Profit & Loss Statement

Roseburg Office: 605 SE Kane St, Roseburg OR 97470 Ph: 541-673-4909 Fax: 541-673-5023North Bend Office: 1984 Sherman Ave, North Bend OR 97459 Ph: 541-756-1000 Fax: 866-572-1970Gold Beach Office: 29692 Ellensburg Ave Suite #7, PO Box 1862, Gold Beach OR 97444Ph: 541-247-9638 Fax: 866-908-4276APPLICANT 1FORECLOSURE INTERVENTION INTAKE FORMPlease Print ClearlyName:FirstMiddle InitialLastAddress:Street AddressPO BoxCityHome Ph:StateWork Ph:Cell Ph:Email:Age:Social Security Number:Race:CountyOther Ph:Preferred Language:Birth Date:How did you hear about us?Zip/Gender:MaleFemale/Please Circle All That ApplyAlaskan NativeAmerican IndianAmerican NativeHispanic:AsianBlack/African AmericanHispanicYesNative HawaiianPacific IslanderWhiteNoPlease Circle Highest Level of Education CompletedEducation:Graduate SchoolCollegeVocationalJunior CollegeHigh School / GEDJunior High SchoolPrimaryOtherNonePlease CircleMarital Status:Single AdultMarried w/ ChildrenMarried w/o ChildrenFemale Headed Single Parent HouseholdMale Headed Single Parent HouseholdDivorcedWidowedSeparatedPlease Circle All That ApplySources of Income:EmploymentSelf EmploymentSSI/SSDUnemploymentRental IncomeAlimony / Child SupportPensionOther:Please Put Annual Gross Income for Entire HouseholdHousehold Gross Annual Income:Type of Housing:Date Revised - 12/24/2014 Please CircleSingle FamilyCondominiumApartmentMobile In ParkMobile On LandLiving w/ Family/FriendsPage 1 of 3

APPLICANT 1 CONT.FORECLOSURE INTERVENTION INTAKE FORMPlease Answer All QuestionsYesNoAre you a Veteran?Were you born in the United States?Please Print ClearlyYesNoAre you Disabled?YesNoDisabled Dependents?YesNoIs Applicant 1 Head of Household?YesNoDo you live in a Rural Area?YesNoAre you in the Active Military?YesNoNumber of People living in household?Ages of Dependents:APPLICANT 1 EMPLOYMENTPlease Print ClearlyEmployer:Hire Date:Your Title:Business Type:Monthly Gross Income:Monthly Net CANT 2MonthlyPlease Print ClearlyName:FirstMiddle InitialHome Ph:Work Ph:Cell Ph:Email:Other Ph:Preferred Language:Birth Date:Age:Social Security Number:Race:Last/Gender:MaleFemale/Please Circle All That ApplyAlaskan NativeAmerican IndianAmerican NativeHispanic:AsianBlack/African AmericanHispanicYesNative HawaiianPacific IslanderWhiteNoPlease Circle Highest Level of Education CompletedEducation:Graduate SchoolCollegeVocationalJunior CollegeHigh School / GEDJunior High SchoolPrimaryOtherNonePlease CircleRelationship toApplicant 1:Spouse / PartnerSiblingEmployerFriendParentOtherRoseburg Office: 605 SE Kane St, Roseburg OR 97470 Ph: 541-673-4909 Fax: 541-673-5023North Bend Office: 1984 Sherman Ave, North Bend OR 97459 Ph: 541-756-1000 Fax: 866-572-1970Gold Beach Office: 29692 Ellensburg Ave Suite #7, PO Box 1862, Gold Beach OR 97444 Ph: 541-247-9638 Fax: 866-908-4276Date Revised - 12/24/2014Page 2 of 3

APPLICANT 2 CONT.FORECLOSURE INTERVENTION INTAKE FORMPlease Circle All That ApplySources of Income:Please Print ClearlyEmploymentSelf EmploymentSSI/SSDUnemploymentRental incomeAlimony / Child SupportPensionOther:Are you a Veteran?YesNoAre you Disabled?YesNoPlease Answer All QuestionsAre you in the Active Military?Were you born in the United States?APPLICANT 2 EMPLOYMENTHire Date:Your Title:Business Type:Monthly Gross Income:Monthly Net CIAL SITUATIONMonthlyPlease Print ClearlyCan you document your child support/alimony income?YesNoAre you currently in Chapter 13 Bankruptcy?YesNoIf yes, when did it begin?If yes, how much is the payment?NoPlease Print ClearlyEmployer:Paid:YesIf yes, how long will it continue?if yes, when will it be paid out? Have you had a Chapter 7 Bankruptcy?YesNoAre there any liens or judgments' against you or your property?YesNoIf yes, when was it discharged?AUTHORIZATIONPlease Print ClearlyI authorize NeighborWorks Umpqua to:Obtain a copy of the HUD-1 Settlement Statement, Appraisal, and Real Estate Note(s) when I purchase/refinance a home fromthe lender who made me a loan and/or Title Company that closed the loan.I hereby verify this information to be true and accurate to the best of my knowledge, and if asked can prove accuracy of the information. Iunderstand the fee I am paying is non-refundable. I identify the person(s) signing the registration form to be the customer(s) receivingservices from NeighborWorks Umpqua.Applicant 1DateApplicant 2DateRoseburg Office: 605 SE Kane St, Roseburg OR 97470 Ph: 541-673-4909 Fax: 541-673-5023North Bend Office: 1984 Sherman Ave, North Bend OR 97459 Ph: 541-756-1000 Fax: 866-572-1970Gold Beach Office: 29692 Ellensburg Ave Suite #7, PO Box 1862, Gold Beach OR 97444 Ph: 541-247-9638 Fax: 866-908-4276Date Revised - 12/24/2014Page 3 of 3

FINANCIAL INFORMATIONINCOMEType of Income: (if none, please put "0")Alimony/Child SupportDependent SSI IncomeDisability IncomePension IncomePublic AssistanceRental IncomeSalary/WagesSelf-Employment IncomeSocial SecurityUnemployment IncomeOther IncomeFORECLOSURE INTERVENTION INTAKE FORMApplicant 1Monthly AmountPlease Print ClearlyApplicant 2Monthly AmountLIQUID FUNDS / SAVINGS / INVESTMENTSApplicant 1Please list the approximate value of the following: (If none, please put "0")Checking AccountsSavings AccountsCash on HandCDsSecurities (Stocks/Bonds/etc.)Retirement AccountsOther Liquid FundsApplicant 2OTHER ASSETSApplicant 1Please list the approximate value of the following: (If none, please put "0")HouseAutomobilesRV (Motor Home, Camper, Trailer, Boat, etc.)Business EquipmentBusiness InventoryOther Property/Buildings Besides ResidenceOther AssetsApplicant 2LIABILITIESApplicant 1Please list the approximate balance of the following: (If none, please put "0")First MortgageSecond MortgageAuto LoansStudent LoansOther LoansCredit CardsMedical DebtUnpaid Property/Income TaxesOther DebtApplicant 2TOTAL AMOUNT - NOT MONTHLY PAYMENTRoseburg Office: 605 SE Kane St, Roseburg OR 97470 Ph: 541-673-4909 Fax: 541-673-5023North Bend Office: 1984 Sherman Ave, North Bend OR 97459 Ph: 541-756-1000 Fax: 866-572-1970Gold Beach Office: 29692 Ellensburg Ave Suite #7, PO Box 1862, Gold Beach OR 97444 Ph: 541-247-9638 Fax: 866-908-4276Date Revised - 12/24/2014Page 1 of 1

605 SE Kane StreetRoseburg, OR 97470Phone: 541 673-4909Fax: 541 673-5023Foreclosure Intervention ApplicationHomeowner Info:Client Name(s):Are you still living in your home? Yes/NoName and phone number of someone who would definitely know how to find you if you moved:Mortgage and Property Information:First MortgageSecond MortgagePayment Do you pay taxes and insurancewith your payment? Yes NoAre your taxes and Insurancecurrent? Yes NoDo you pay association fees withyour payment? Yes NoMortgage Company:Third MortgagePayment Mortgage Company:Payment Mortgage Company:Interest Rate: %Interest Rate: %Fixed ARMDelinquent?Fixed ARM Yes No Yes NoDelinquent?Months Delinquent:Months Delinquent:Amount Delinquent: Amount Delinquent: Interest Rate: %Fixed ARMDelinquent? Yes NoMonths Delinquent:Amount Delinquent: Has home been refinanced? Yes NoHow many times? 1 2 3 4 or moreDate of last refinance?Have you been in contact with your lender? Yes No Loan Modification ForbearanceHave you had any of the following ‘workouts’?What is your ideal situation for your home? Keep itHave you listed your home with a real estate agent? Sell it Yes NoReal Estate Agent:Have you had an appraisal in the last year?Have you received a Notice of Default? Yes No Repayment Plan Trial Period Plan I’m not sureList Price Contact Info:Time on Market? 0-3 months 6-12 monthsIntake Form (Rev 10/24/12) Yes No 3-6 months More than one year

605 SE Kane StreetRoseburg, OR 97470Phone: 541 673-4909Fax: 541 673-5023In a few sentences, please explain what event(s) have caused you to fall behind in your mortgage. Be as specific and honestas possible. List dates, people involved, etc.What is the current condition of your home? (Ex. It needs some repairs, it is in good condition, it is worth less than I owe,etc. Be specific.What is your current financial situation? Are you expecting your income to increase in the near future? Be specificregarding sources of current income, potential income, lump sums of money expected, gifts, etc.During the foreclosure mitigation process NeighborWorks Umpqua will act on your behalf to speak with loanservicers and others regarding the resolution of your housing situation. In order to do this in the best possibleway, you will need to provide the counselor on your first appointment with the required documentation andpaperwork. Please come to the appointment with all paperwork filled out and be ready to work on aresolution. Mortgage Note and Deed of Trust - All pages Mortgage Statements- Most recent, need all pages for 1st & 2nd Mortgages Letter from your mortgage company regarding your delinquency Utility Bills - Most recent, needed to prove residency 2 Months Bank Statements- Most recent, for all accounts, all pages 2 Most Recent Federal Tax Returns- Most recent, page two must be signed & dated Drivers License 1 Month Proof of Income(s) Paystubs for most recent 30 day period Social Security Award Letter Proof of pension Unemployment Benefit Statement Other Income: If Self-Employed YTD Profit & Loss StatementIntake Form (Rev 10/24/12)

REFERRAL FOR TRANSLATION SERVICES FORMFor clients requiring any non‐English speaking services the following list of resources is being madeavailable to assist you:Language Line Services (888‐808‐9008)Client Signature:Date:Counselor Signature: Date:

605 SE Kane StreetRoseburg, OR 97470Phone: 541 673-4909Fax: 541 673-5023Client/Counselor AgreementNeighborWorks Umpqua and its counselors agree to provide the following services: Development of a spending planAnalysis of the mortgage default, including the amount and cause of defaultPresentation and explanation of reasonable options available to the homeownerAssistance communicating with the mortgage servicer and other creditorsTimely completion of promised actionExplanation of collection and foreclosure processIdentification of assistance resourcesReferrals to needed resourcesConfidentiality, honesty, respect and professionalism in all servicesI/We, agree to the following terms of service: I/We will always provide honest and complete information to my/our counselor, whether verballyor in writing.I/We will provide all necessary documentation and follow-up information within the timeframerequested.I/We will be on time for appointments and understand that if we are late for an appointment, theappointment will still end at the scheduled time.I/We will call within 6 hours of a scheduled appointment if I/we will be unable to attend anappointment.I/We will contact the counselor about any changes in our situation immediately.I/We understand that breaking this agreement may cause the counseling organization to sever itsservice assistance to e Form (Rev 10/24/12)

605 SE Kane StreetRoseburg, OR 97470Phone: 541 673-4909Fax: 541 673-5023Foreclosure Mitigation Counseling Agreement/Third Party Authorization FormIn order to provide the best possible services, it may be necessary for NeighborWorks Umpqua to communicate withindividuals or agencies that may be able to assist in the resolution of your foreclosure, or to acquire services thereafter. Bysigning below you agree that:1. I understand that NeighborWorks Umpqua provides foreclosure mitigation counseling after which I will receive a writtenaction plan consisting of recommendations for handling my finances, possibly including referrals to other housing agenciesas appropriate.2. I understand that NeighborWorks Umpqua received Congressional funds through the National Foreclosure MitigationCounseling (NFMC) program and, as such, is required to share some of my personal information with NFMC programadministration or their agents for purposes of program monitoring, compliance and evaluation.3. I give permission for NFMC program administrators and/or their agents to follow-up with me for up to three (3) yearsfrom the date of this signed form for the purposes of program evaluation.4. I acknowledge that I have received a copy of NeighborWorks Umpqua’s Privacy Policy.5. I understand that I may be referred to other housing agencies of the organization or another agency or agencies asappropriate that may be able to assist with particular concerns that have been identified. I understand that I am notobligated to use any of the services offered to me.6. I understand that a counselor may answer questions and provide me information, but not give legal advice. If I want legaladvice, I will be referred for appropriate assistance.7. I understand that NeighborWorks Umpqua provides information and education on numerous loan products and housingprograms and I further understand that the housing counseling I receive from NeighborWorks Umpqua in no way obligatesme to choose any of these particular loan products or housing programs.By signing this form, you acknowledge that you are entering into a counseling agreement with NeighborWorks Umpqua.We will make any and all attempts to resolve your situation and to guide you through the process of reviewing youroptions. This is in no way a guarantee of results and NeighborWorks Umpqua is in no way legally responsible for theoutcome of this counseling. By not signing this form, you understand that NeighborWorks Umpqua may not perform anydefault counseling services on your behalf.SignatureDateSignatureDateIntake Form (Rev 10/24/12)

605 SE Kane StreetRoseburg, OR 97470541-673-4909 phone541-673-5023 faxAuthorization to Release InformationBorrower:Las

NeighborWorks Umpqua Forms: Intake Form (2 Pages) Foreclosure Intervention Application (2 Pages) Referral For Translation Services Form (1 Page) Client/Counselor Agreement (1 Page) Foreclosure Mitigation Counseling Agreement/ Third Party Authorization Form (1 Page)

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