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Your Contact Information
Best Time to Call:
First Name:
Day Phone:
Last Name:
Evening Phone:
E-Mail:
 Mobile Phone:
Your Situation
Yes
No
Has your lender started the foreclosure process on your home?
What's your situation? How did you fall behind on your mortgage payments?
Yes
No
Type of Residence of this Property:
Type of Property:
Is the house currently listed for sale?
If yes, how long has your house been for sale?
Your Property Information
City:
Address:
State:
Zip:
 How long have you owned this house?
Financial Information
Please provide the following information on your mortgage(s) and current financial situation...
1st Mortgage                         2nd Mortgage                        3rd Mortgage
Lender's Name:
Balance you owe:
Monthly Payment:
Current Rate:
Rate Type:
Yes
 Yes
 Yes
No
 No
 No
Payments Current?
If No, how far behind?
How much are your total annual property taxes?
Yes
No
Are your property taxes and insurance included in your monthly payment?
If your house were appraised, how much do you think it would be worth?
Yes
No
Are you currently in a Chapter 7 or 13 Bankruptcy?
Yes
No
Are you currently capable of making your minimum monthly payments on all your debts?
How did you hear about us?
Do you have any questions or comments you would like to share with us?
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©2008 First Liberty Law Group, PLLC, www.FirstLibertyLaw.com, All Rights Reserved
                                                                                        Legal Disclaimer

The advertising material on this web site has been prepared by First Liberty Law Group, PLLC. for informational purposes only, and is not intended to contain or constitute legal advice for any particular case
or situation. No attorney-client relationship is established by virtue of your visiting this web site, and nothing sent to this law firm by e-mail from the site shall constitute or establish an attorney-client
relationship. The information contained in this web site is provided only as general information, which may or may not reflect the most current legal developments.  All work performed by First Liberty Law
Group, PLLC. is done either by an attorney or under an attorney’s supervision.

First Liberty Law Group, PLLC. accepts clients we believe, based on the information provided to us, can afford to remain in their home but need help in working with their lender and or servicer.  However, we
make no guarantees about the outcome of your case, and the final decision on whether to permit a modification or other relief belongs to the lender or servicer.
TM
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800-935-3593